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Home My WebLink About20190259.tiffUSE BY SPECIAL REVIEW (USR) APPLICATION DEPARTMENT OF PLANNING ER ''I E * 1555 N. r17T" AVENUE * GREELEY, CO 80631 w w. e I dgov .corn * 970-400-6100 ' FAX 970-304-6498 FOR PLANNING DEPARTMENT USE: AMOUNT $ APPLICATION RECEIVED BY Parcel Number. Address of site: DATE RECEIVED: CASE # ASSIGNED: PLANNER ASSIGNED: *1 4 7 7_3 o_ 2 _0 0 O 3 0 See attached Legal Description: See attached Zone District: Ag riculturlAcreage: 91 FEE OWNER(S) OF THE PROPERTY: Name: Matthew T. Berghorn (*A► 12 digit number on Tax ID, Information; obtainable at rw.weldgov.+com). Section:30 Township: 'I N Range: 63 Floodplain: 1 1 eological Hazard: YCI r Airport Overlay: Y I Company: Discovery DJ Services, LLC Phone #: 303495-4853 Email: MBerghorn©discovery►midstream 4 COM Street Address: 7859 Walnut Hill Lane, Suite 335 City/State/Zip Code: Name: Dallas, TX, 75230 Company: Phone #: Email: Street Address: City/State/Zip Code: Name: Company: Phone #: Email: Street Address: City/State/Zip Code: APPLICANT OR AUTHORIZED AGENT: (See below: Authorization must accompany all applications signed by Authorized Agents) Name: Matthew T. Berghorn Company: Discovery DJ Services, LLC Phone #: 3034954853 Email: MBerghom@discoverymidstream.m Street Address: 7859 Walnut Hill Lane, Suite 335 City/State/Zip Code: Dallas, TX, 75230 PROPOSED USE: Installation of a 24 -inch Natural Gas Pipeline. I (We) hereby depose and state under penalties of perjury that all statements, proposals, and/or plans submitted with or contained within the application are true and correct to the best of my (our)knowledge. Signatures of all fee owners of property must sign this application. If an Authorized Agent signs, a letter of authorization from all fee owners must be included with the application. If a corporation is the fee owner, notarized evidence must be included indicating that the signatory has to legal auth ' rity to sign for the ea• rporat' . ns rvia. TT ,r is - - r gnature: Owner or Auth ri ed Agent Date Signature: Owner or Authorized Agent Date M.OriftkViren ..J2( iri& Print Name Print Name Rev d vve DISC 0 VERY MIDSTREAM PARTNERS November 15, 2017 Mr. Kim Ogle Weld County Department of Planning 1555 North 17th Avenue Greeley, Colorado 80631 Dear Mr. Ogle, This letter serves as confirmation of Matt Berghorn's authority to sign on the behalf of Discovery DJ Services LLC. Per the Company agreement — "The Board may assign titles to particular Officers. Unless the Board decides otherwise, if the title of an Officer is one commonly used for officers of a business corporation formed under the Texas Business Organizations Code (or any successor statute), the assignment of such title shall constitute the delegation to such Officer of the authority and duties that are normally associated with that office, subject to any specific delegation of authority and duties made to such Officer by the Board," Matt has been delegated by the Board the title of Vice President, Engineering & Construction. Thanks for your time and consideration. If you have any questions, please feel free to contact me directly at the extension 105 via office number listed below. Regards, Michael B. Davis Chairman Cc: Cory Jordan Discovery Midstream Partners 7859 Walnut Hill Lane, Suite 335 j Dallas Texas 75230 J 214.414.1980 I DiscoveryMidstrearn.com DISC o VERY TO: PREI 8-0243 DATE: August 23, 2018 SUBJECT: Pre -Application Meeting prior to submitting USR for 24 -inch pipeline ATTENDEES: Scott Elery, Applicant Evan Pinkham, Public Works Michelle Martin, Planning On Thursday, August 23, 2018 an informal discussion took place at the Greeley Administrative Offices regarding a proposed 24 -inch pipeline approximately 9-25 miles in length. The LAP process was brought up for this pipeline project, but Discovery will submit this project as a Use by Special Review (USR). DISC D VERY Proposed Pipeline: Keenesburg PRE1S-0243 Planning Questions: 1. Explain, in detail the proposed use of the property. Response: The Keenesburg pipeline is a proposed 24 -inch natural gas pipeline, that will eventually connect Discovery DJ Services LL's Fort Lupton Gas Processing Plant (USRII-0059) with the Keenesburg Gas Plant to increase production efficiency. The selected route is approximately 9.25 miles long and is deemed to be the most direct route, which will minimize impact on the community, minimize cost and maximize safety during construction. This pipeline project begins in Arapahoe County (the Houlihan pipeline), travels North through Adams County (the Watkins pipeline), to the Weld County Line at E. 168th Avenue and County Road 63 and will continue north ending at the Keenesburg Gas Plant currently under construction. The proposed pipeline route crosses unincorporated Weld County and a portion of the Town of Keenseburg. The preferred route begins 1.50 miles north of E. r1681h Ave / County Road 2. The project will travel approximately .41 miles north before turning east for approximately .52 miles, turns north for approximately 6.33 miles, turns east for approximately .62 miles, crossing under Interstate 76 Frontage Road (398), travels north for approximately 1.15 miles ending a the proposed Keenesburg Gas Plant in Section 18, Township 2 North, Range 63 West. The total length of the proposed pipeline is 9.25 miles. Discovery DJ Services, LLC is acquiring a 0 -foot wide (55 +/- acres in linear area) permanent easement along the pipeline route, along with a 0 -foot wide (90 +/- acres in linear area) temporary work space. Upon completion of the proposed natural gas pipeline, all lands disturbed will be reclaimed as near to prior conditions. The 24 -inch natural gas pipeline will be constructed within the following Township, Range and Sections: Townshi • Ranee Section 1 North I North I North North 2 North 2 North 2 North 2 North 2 North 63 West 63 West 63 West 63 West 63 West 63 West 63 West 63 West 63 West 19 18 7 6 31 30 20 19 17 1 DISC m VERY Proposed Pipeline: Keenesburg PRE1S-O243 Pipeline maps showing, planned location and route of the natural gas pipeline Right of Way (ROW) and permanent easements are provided with this application. All steel pipelines constructed to 49 CFR Part 192/195 DOT standards for gas crude oil pipelines. The natural gas pipeline will be constructed of API 5L, X-65 pipe, with a 0.375" wall thickness for the line pipe and a 0.500" wall thickness for all crossing pipes. The pipe will be coated with fusion bond epoxy for external corrosion protection. All city and county roads, and other crossings will be crossed by horizontal drill ('HDD"), thereby avoiding surface impacts in these areas. Discovery will comply with all requirements for construction within unincorporated Weld County, as well as the Nationwide Plan 12 permit for all waterways crossings, which allow waterways to be open cut or bored depending on the condition of the waterway. The following table summarizes key information for the natural gas pipeline. Keenesburg Natural Gas Pipeline Pipeline Diameter 24.0" O.D. Line Pipe Wall Thickness .375" W.T. Pipe Wall Thickness Crossing .500" WI. Yield Strength 65,000 psi (X-65 Grade) Approximate Pipeline Length 9.35 Miles Total Parcel / Tract Count 25 All pipelines will be buried to provide minimum of 48 -inch of cover. The pipeline trench will be excavated mechanically; pipe segments will then be strung along the ditch line and then welded together using welders and weld procedures qualified under the requirements of the Code of Federal Regulations; each weld will be examined utilizing industry standard non-destructive examination, or x-ray, procedures by qualified technicians; the coating on the pipeline will be inspected for damage and repaired as necessary and then the line will be lowered into the trench and backfilled. The pipeline will subsequently be pressure tested using water (hydrostatically tested) to industry regulations. All available topsoil will be conserved through a process known as "double -ditching", which excavates and removes and conserves topsoil where practical. Consented topsoil will be windrowed separately form the underlying subsoil and stored along the construction right-of-way until the trench is backfilled. During construction, Discovery will follow BMP's described in the Stormwater Management Plan. Erosion control BMP's include silt fencing, straw wattles, hay bales, sediment control log, reinforced rock berm, etc., or combinations of these items, depending on the particular area requiring erosion control during construction. Construction staking will occur to designate the pipeline centerlines and outside construction right-of-way boundaries. The limits of disturbance will be clearly marked/staked prior to construction including the construction right-of-way, temporary use areas/work space, and access roads. Utility lines will be located and marked to prevent S DISC o VERY Proposed Pipeline: Keenesburg PREI8--0243 accidental damage during pipeline construction. Sensitive areas to be protected from disturbance or that require monitoring will be indicated on engineering documents and location of access road entry points will be properly marked. Flagging, signs, and other markings identifying the limits or disturbance would be maintained through all phase of construction. A survey crew would be available during construction to replace any stakes that have been damaged or inadvertently removed. Clearing and Grading; : `egetation wall be cleared, and the construction right-of-way would be graded, to the degree necessary, to provide for safe and efficient operation of construction equipment and vehicles and to provide space for the storage of subsoil and topsoil. Construction activity and ground disturbance will be limited to approved, staked areas. Where required, trees will be cut with a chain saw and/or mechanical shears and brush would generally be cut with a hydro -axe or similar equipment. Trees and brush will be cut as close to the ground as possible. Vegetative material will typically be shredded and scattered back across the surface to increase roughness, facilities seeding establishment, and protect the construction right-of-way. Stumps that are not shredded or shipped and that are incorporated into the topsoil will be removed and disposed of at an approved disposal facility. Vegetation may also be brush - hogged to preserve habitat, Topsoil will be stockpiled separately from subsoil and will not be used to pad the trench or construct trench breakers. In areas where the construction right-of-way crosses ephemeral drainages, the drainages will not be blocked with topsoil or subsoil piles. Topsoil and subsoil would be placed on the banks of the drainages. Gaps will be left periodically in the topsoil would be placed on the banks of the drainages. Gaps will be left periodically in the topsoil and subsoil piles to avoid ponding and excess diversion of natural runoff during storm events. Trenching: Trenching will be completed using track hoes or a mechanical trenching machine. The pipeline trench will be to one side of the construction right-of-way to allow for spoil to be placed opposite of the wider working side. It is not anticipated that blasting will be required during pipeline construction. Access will provide for landowners and grazing rights holders to move vehicles, equipment, and livestock across the trench where necessary and consistent with prior agreement with landowners. Livestock operators will be contacted, and adequate crossing facilities would be provided as needed to ensure livestock are not prevented from reaching water sources because of the open trench. T h e contractor will keep wildlife and livestock trails open and passable by adding soft plugs (areas where the trench is excavated and replaced with minimal compaction) during construction. Soft plugs with ramps on either side will be left at all well-defined livestock and wildlife trails and at no more than 0.5 -miles intervals along the open trench t allow passage across the trench and to provide a means of escape for livestock and wildlife that may fall into the trench. 6 DISC o VERY Proposed Pipeline; Keenesburg PRE1S-0243 Trench breakers constructed of sand bags or polyurethane foam will be installed at specific spacing intervals to impede shallow groundwater from flowing down the trench. Lowering -in and Padding: Before the pipe section is lowered into the trench, an inspection will be conducted to verify that the pipe is properly fitted and installed in the trench, minimum cover is provided, and the trench bottom is free of rocks and other debris that could damage the external pipe coating. The pipe sections will be simultaneously lifted in position over the trench and lowered into place. Sifted soils fines from the excavated subsoil will provide rock -free pipeline padding and bedding. Sandbags may be used to pad the bottom of the trench instead of, or in combination with, padding with soil fines. In rocky areas, padding material or a rock shield will be used to protect the pipe and coating. Topsoil will not be used to pad the pipe. Backfilling Pipeline: Shading and backfill will begin after a section of pipe has been successfully placed in the trench, inspected, and approved for backfill. Backfill will be conducted using a bulldozer or other suitable equipment. Subsoil excavated from the trench will generally be used to backfill the trench, except in rocky areas where imported select fill material may be needed. Backfill will be graded and compacted, where necessary, for ground stability, by tamping or waling with a wheeled or tracked vehicle. Compaction will be conducted to the extent that there would be no voids in the trench. Any excavated materials or materials unfit for backfill will either be utilized elsewhere or properly disposed of in accordance with applicable laws, regulations and landowners' agreements. 2. Explain how this proposal is consistent with the intent of the Weld County Code, Chapter 22 of the Comprehensive Plan. Peons+: Advances in oil and gas extraction technologies have resulted in a substantial increase in oil and gas activities across Colorado. Crude oil and produced liquids (condensate, produced water) from these wells impede the natural gas production and require transportation to oil and gas facilities for processing, treatment, and either disposal or sale to regional markets. Currently, these liquids are transported by truck from the individual well pads resulting in an increasing number of trucks per day on the local city and county roads and state highways. Similarly, the existing natural gas infrastructure in and around these wells is a capacity or doesn't exist within areas of new drilling. Centralized collection of these liquids and more efficient means of transportation are required to reduce the local truck traffic and facilitate transportation of the natural gas produced liquids to locations where they can be processed and sold to meet market demands. The Project is a necessary component to the overall system to gather, process, transport and market the area's natural resources in the Niobrara and Codell formations. Section 22--2-10(D) of the Weld County Code states that "extraction of natural resources is an important part of the economy of the County." The proposed 24 -inch natural gas pipeline will contribute to the expansion of the county's industrial economic base by transportingvaluable resources and contributing to the increased capacity for future marketing of natural gas production in Weld County. In addition, the pipeline is below grade and, therefore, will not affect anything above grade after construction. 7 DISC o VERY Proposed Pipeline: Keenesburg PRE1 -0►243 Section 22-22-80(C) states that "The land use applicant should demonstrate that the roadway facilities associated with the proposed industrial development are adequate in width, classification, and structural capacity to serve the development proposal." The new development proposal will not affect traffic in such a way as to conflict with current transportation infrastructure, as the pipeline will be built within a Right -of -Way and any roads will be bored under, rather than trenched across. The pipeline will comply with all federal, state, and local policies and legislation per Section 22-2-80(E). Section 22-2-90(C) states that, due to the over capacity of pipelines and refineries in the state, there is an increase in need for transportation and storage. The most efficient and safe way to transport natural gas is by pipeline because it negates the need for the transportation of this resource by truck. This benefits the county by allowing for less impact on county roads, minimal impact on land, better air quality, and the economic advantages that pipeline infrastructure brings. 3. Explain how this proposal is consistent with the intent of the Weld County Code, Chapter 23 (Zoning) and the zone district in which it is located. Repon_ Section 23-3-40 identifies that oil and gas production infrastructure is allowed as a use by right in agricultural zone districts. Section - -40 i nd icates that oil and gas support, service, and pipelines are acceptable as a Use by Special Review within the district. Any impacts to actively cultivated land by the project will be temporary, and agricultural operations can resume once the pipeline is operational. The proposed pipeline meets the objectives outlined in the Weld County Code Comprehensive Plan without rezoning or changing the use of the land. 4. Describe what type of land uses surround the site. Explain how the proposed use is consistent and compatible with surrounding land uses. Response; The proposed pipeline route is primarily located in unincorporated Weld County in the agricultural zone district. The surrounding land usage for the proposed route primarily consists of plowed fields, pivot irrigation systems, and country homes. The pipeline will be buried beneath the ground's surface and therefore the effect on any active agriculture will be temporary and isolated to the construction phase of the project. The project is consistent and compatible with the surrounding land uses as a use allowed by right under Weld County Code Section 23-3-20. A total of 16 crossings, including county roads, sections and irrigation canals are required within Weld County. The table below summarizes the Weld Cunty road crossings required along the preferred route. A complete list of other feature crossings along the preferred route is outlined in the following table: a DISC o VERY Proposed Pipeline: Keenesburg PRE18-0243 Weld County Road Crossings No. Road Crossed Nearest Intersection Distance to Intersection (Approximate) CR 6 CR6 &CR 63 1,001 ft. East CR 8 CR S& R 61 2,810 ft. East CR10 CR 10 & cR 61 2,843 ft. East CR 12 CR 12 & CR 61 2,671 ft. East R14 CR14 & CR61 2,721 ft. East 6 i CR 16 1/2 CR 16 10 2 & CR 63 2,737 ft. West 7 CR 18 CR 18 & CR 63 2,563 ft. West CR 63 CR 63 & D R 18 3,764 ft. North Weld County Non -County Road Crossings No. Type Feature of Name/Description Approximate Crossing Location 1 Interstate Interstate 76 Frontage Road 40° 07' 44.58" N, 104° 28' 12.49" W BN F Railroad 40° 07' 43.40" N4 104° 28' 07.91" W 2 Railroad 3 Highway Highway 52 400 04' 23.32" N, 104° 28' 48.72" W 40° 06' 15.57" N 104° 28' 50.50" W Creek Creek crossing Ditch Low Line 40° 05' 13.81 " N, 104° 28' 49.55" W Ditch Ditch Crossing 40° 04' 23.80" N, 104° 28' 48.93" W 7 Creek Lost Creek 40° 02' 52.11" N, 104° 28' 38.13" vv Ditch 1053 Lateral 40° 03' 31.72" N, 104° 28' 46.14" W Road Crossing: All county road crossings will be completed by directional drill methodology with sufficient depth to maintain a minimum of 60-inces of cover at the lowest bar ditch. ''aterbody Crossing: All streams and named ditch/canal crossing will be completed by directional drill ("HDD") to avoid disturbance of the stream and ditch bed and banks. Each HDD will begin, end and be of sufficient depth to ensure the pipeline is not subject to the hazard of stream scour during anticipated flood events. If the HDD crossing avoids impact to all associated wetlands, A U.S. Army Corps of Engineers (USACE) 404 permit will not be necessary for this project. 5. What are the hours and days of operation? (e.g. Monday thru Friday 8:00 a.m. to 5:00 p.m.) Response: During construction 7 days a week, 6:00AM to 6:00PM. After construction this is an unmanned project. The hours of operation or the pipeline will be 24 hours per day, 7 days per week, 365 days per year. 9 DISC o VERY Proposed Pipeline: Keenesb►urg PRE18-0243 6. List the number of full time and/or part time employees proposed to work at this site. ResDonse; During construction, approximately 35-50 construction personnel, including the construction contractor and Discovery's Construction Management Team, ►rill be required to construct the pipeline along the rig ht -of• -way. The operation and maintenance of the pipeline will be performed by trained and qualified operators and pipeline technicians. After construction there will be no full-time and/or part-time employees associated with the proposed project. If shift work is proposed include the number of employees per shift. Response: There will be no shift work associated with the proposed project. 8. List the number of people who will use this site. Include contractors, truck drivers, customers, volunteers, etc. Response: During construction, approximately 35-50 construction personnel, including the construction contractor and Discovery's Construction Management Team, will be required to construct the pipeline along the right-of-way. The operation and maintenance of the pipeline will be performed by trained and qualified operators and pipeline technicians. 9. If this is a dairy, livestock confinement operation, kennel, etc., list the number and type of animals. Response: No animals will be on site. 10. Describe the type of lot surface and the square footage of each type. (e.g. asphalt, grave!, landscaping, dirt, grass, buildings). Response: The pipeline will be cut and filled with the original grading surface. The right- of-way will be re -seeded after completion of the pipeline to return the area to original condition. 11. How many parking spaces are proposed? How many handicapped (ADA) parking spaces are proposed? Response: The pipeline will run within the right-of-way and will not require parking. 12. Explain the existing and proposed landscaping for the site. Response: Following construction, the right-of-way and all disturbed areas will be restored to their pre -construction conditions and contours. Agricultural land will return to agricultural uses, native grassland habitats will be reseeded. Invasive and noxious weeds will be controlled alter construction to minimize further propagation pursuant to Chapter 15, Articles I and II of the Weld County Code, until the right-of-way is restored. No additional landscaping is proposed. 10 DISC 0 VERY Proposed Pipeline: Keenesburg PRE1S-O243 13. Describe the type of fence proposed for the site (e.g. 6 -foot chain link with earth tone slats). Response: The pipeline will be below grade and therefore not require a fence. 14. Describe the proposed screening for all parking and outdoor storage areas. If the site is located in a floodplain outdoor storage is restricted. Response: Because no parking or storage areas are associated with this project, no screening will be necessary. 15. Explain any proposed reclamation procedures when termination of the Use by Special Review activity occurs, Response: During operations of the pipeline, should it become necessary to decommission a portion of the line for maintenance or repair activities, pressure on the pipeline would be reduced to a safe operating pressure, or completely blown down utilizing blowdown valve(s). All decommissioning activities would be performed using written procedures designed for the specific requirements and situations. As part of the decommissioning plan, all local emergency responders would be notified in advance and affected landowners notified, as necessary. There is no intention of ceasing operations of the pipeline once it is operational. However, in the event that any portion of the pipeline system is permanently decommissioned, that portion will be evacuated, cleaned, isolated, and abandoned in place or removed per all state and local regulations and per the respective landowner agreements. 16. Who will provide fire protection to the site? Response: Southeast Weld Fire Protection District. Discovery maintains an ongoing working relationship with these fire districts and will reach out to them to review the upcoming project to review Discovery's response plan. The pipeline will be covered under an Emergency Response Plan. The pipeline will be designed and constructed per code. Control and shut off valves will be strategically placed along the pipeline route and are required to be inspected twice a year on our mainline system, overpressure protection devices will be installed and inspected annually or as required by code. Additionally, a hydrostatic test will be performed prior to start u p . The pipeline will be protected with a leak detection system and monitored by a 24 -hour control room through a SCADA system. The pipeline will be identified through pipeline markers. The pipeline will be cathodically protected to mitigate corrosion as well as above ground portions will be inspected through an atmospheric inspection program. Company employees are covered under training programs, including our Operation Qualification Program. Moreover, the company follows a detailed Public Awareness program. Discovery maintains an emergency response plan (copy included) which addresses responses to leaks or spills. This response plan contains detailed information on the steps needed to address any emergency event reasonably anticipated to be encountered during pipeline operations. The response plan contains contact information, detailed step by step 11 DISC o VERY Proposed Pipeline: Keenesburg PRE18-0243 spill/leak response information, emergency phone numbers for local responders and spill/leak contractors. The response plan is reviewed on a regular basis. 17. List all proposed on -site and off -site improvements associated with the use (e.g. landscaping, fencing, buildings, drainage, turn lanes, etc.) and a timeline of when you will have each one of the improvements completed. Response: Cleanup and restoration will occur after the pipeline is installed and backfill is complete. Cleanup of the surface along the construction right-of-way will include removal of the construction debris and final grading to the finished contours. Permanent erosion control measures will be installed as required and seeding will occur in accordance with landowner requirements. Invasive and noxious weeds wilt be controlled after construction until the right-of-way is restored. 12 DISC m VERY Proposed Pipeline: Keenesburg PRE18-0243 Engineering Questions: it. Describe how many roundtrips/day are expected for each vehicle type: Passenger Cars/Pickups, Tandem Trucks, Semi-Truck"Trailer/R' (Roundtrip = I trip in and '1 trip out of site). Response: During construction, stringing trucks will be used to haul and string pipe along the length of the right-of-way. Stringing activities are anticipated to take approximately 3- 4 weeks and would start following clearing and grading of the right-of-way and once ditching activities have progressed far enough along the length of the right-of-way to avoid conflicts. in addition, welding trucks and 1 -ton pick-up trucks will be required along the right-of-way for welding activities and construction management personnel. Operations personnel will periodically drive the pipeline route for visual inspection and to perform routine maintenance activities (approximately 2-3 round trips per month). The Proposed Project will not impact the existing transportation network. The temporary increase in traffic during construction will be more than offset by the decrease in truck transport traffic associated with the crude oil liquids production compared to the respective pipeline capacities over the life of the Project. 2. Describe the expected travel routes for site traffic. Response: During construction, the primary travel route to access the pipeline will be from Discovery DJ Services, LLC KeenseburgLaydown Yard located at 8490 County Road 57, Keenseburg, bu rg, o. From the laydown yard traffic will travel east on County Road 8 to Market Street, to 1-76 Frontage Road (398) to County Road 63. From County Road 63 the following Roads can be accessed; 18, 16 1/2, 14, 52 (CR 12), 10, 8, 6 and County Road 61. Depending on which section is being working on will determine which County Road will be used. Construction equipment will be transported to the construction right-of-way via tractor trailer and unloaded within designated staging area(s). Transportation equipment will be removed from the site or parked within a staging area once off-loading is completed. Expected Travel Routes 3. Describe the travel distribution along the routes (e.g. 50% of traffic will come from the north, 20% from the south, 30% from the east, etc.) Response: 100% of the traffic will come from the North. 13 DISC 0 VERY Proposed Pipeline: Keenesburg PREIS-0243 4. Describe the time of day that you expect the highest traffic volumes from above. Res The greatest volume of traffic will occur between 7:00AM 0A —5:00PM Monday through Saturday. After construction is completed, the traffic volume will be very minimal. 5. Describe where the access to the site is planned. Respon_ Temporary access to the pipeline right-of-way will occur at the various County Road crossing. The access will depend on the section of pipe, but in every case, the nearest county road will be taken to the right-of-way. Appropriate Access and Right -of -Way Permits will be obtained once final access points and road crossings along the pipeline have been identified. 6. Drainage Design: Detention pond summarized in a drainage report is required unless the project falls under an exception to stormwater detention requirements per code section 23-12-30 F.1. a. Does your site qualify for an exception to Stormwater detention? If so, describe in a drainage narrative the following: i Which exception is being applied for and include supporting documentation. ii. Where the water originates if it flows onto the property from an offsite source. iii. Where it flows to as it leaves the property. iv. The direction of flow across the property. v. If there have been previous drainage problems with the property. b. Does your site require a Stormwater detention pond? If so, the following applies: i. A drainage report summarizing the detention pond design with construction drawings and maintenance plan shall be completed by a Colorado Licensed Professional Engineer and adhere to the drainage relate sections of the Weld County Code. ii. The drainage report must include a certification of compliance stamped and signed by the PE which can be found on the engineering website. iii. A general drainage report guidance checklist is available on the engineering website. More complete checklists are available upon request. Response: No stormwater detention is required for pipelines and, therefore, an exception is requested. 14 DISCOVERY Proposed Pipeline: Keenesburg PRE1S-O243 Environmental Health Questions: 1. What is the drinking water source on the property? If utilizing a drinking water well include either the well permit or well permit a'ptication that was submitted to the State -Division of Water Resources. If utilizing a public water tap include a letter from the Water District, a tap or meter number, or a copy of the water bill. Response: During construction, bottled water will be made available to construction personnel. Due to the intermittency of personnel on site after construction, a permanent source of drinking water will not be necessary. Personnel and contractors will be responsible for bringing their own drinking waterafter construction. 2. What type of sewage disposal system is on the property? If utilizing an existing septic system provide the septic permit number. If there is no septic permit due to age of the existing septic system, apply for a septic permit through the Department of Public Health and Environment prior to submitting this application. If a new septic system will be installed, please state "a new septic system is proposed". Only propose portable toilets if the use is consistent with the Department of Public Health and Environment's portable toilet policy. Response: Due to the intermittency of personnel on site, a sewage disposal system will not be installed. Portable toilets will be used during construction. 3. If storage or warehousing is proposed, what type of items will be stored? Response: There will be no storage or warehousing for this project. 4. Describe where and how storage and/or stockpile of wastes, chemicals, and/or petroleum will occur on this site. Response: No waste is anticipated to exist poet -construction. General trash will be gathered and disposed of in dumpsters m pste r during the construction phase. 5. If there will be fuel storage on site indicate the gallons and the secondary containment. State the number of tanks and gallons per tank. Response: No vehicle or equipment fuel will be stored on site. 6. If there will be washing of vehicles or equipment on site indicate how the wash water will be contained. Response: There will be no vehicle washing facility for this project. 7. If there will be floor drains indicate how the fluids will be contained., Response: There will be no floor drains for this pipeline project. 15 DISC o VERY Proposed Pipeline: Keenesburg PRE18-0243 8. Indicate if there will be any air emissions. (e.g. painting, oil storage, etc.) Response: During construction, the short-term emission sources impacting air quality will include construction equipment, typically diesel driven, and traffic on the roadways and right-of-way. Discovery plans to utilize water suppression to reduce the amount of fugitive dust generated during construction, as necessary. A Stormwater Management Plan (SWMP) will be prepared as required by the Colorado Department of Public Health and Environment and Stormwater Best Management Practices will be installed for the construction phase in accordance with the SWMP for sediment and erosion control along the right-of-way. Water for dust mitigation and hydrostatic testing will be obtained from permitted sources accordance with the applicable state and local requirements and will be supplied using water trucks. After construction, the pipeline will be below grade. The only air emissions will be from occasional pipeline depressurization during maintenance operations. All required Air Permits will be obtained from the Colorado Department of Public Health & Environment (CDPHE). 9. Provide a design and operations plan if applicable. (egg. composting, landfills, etc.) Response: All of Discovery DJ Services assets in Colorado fall under various Operations and Maintenance Plans as well as Safety Plans, Discovery's Operations team maintains an Emergency Response Plan for all operating assets. The Operations team also maintains a Damage Prevention and Public Awareness Plan. This includes submitting any new pipeline additions to the Colorado One Call System. Discovery DJ Services also maintains an Integrity Management Plan for all of its pipeline systems. The Operations group has a comprehensive Operations and Maintenance Manual for all gas line operations. This plan is subject to an annual review for effectiveness for our operations. • The Operations team will patrol the right-of-way every 7 1/2 months, but at least twice each calendar year. On this patrol, Operations will verify pipeline markers are installed at public road and rail crossings, as well as at all necessary locations to identify the location of the pipeline. • An overpressure protection survey will be completed once every 3 calendar years, not to exceed 39 months, • A valve inspection will be completed at least once per calendar year not to exceed 15 months. A corrosion control program will be put into place for all of Discovery pipelines. This will include a cathodic protection system for all buried pipe. • The cathodic protection system will be checked at least once each calendar year, not to exceed 15 months. The cathodic protection rectifier(s) wilt be inspected six times each calendar year, not to exceed 2 1/2 months. 16 DISC 0 VERY Proposed Pipeline: Keenesburg PRE18-0243 • The pipeline system will also have test stations installed with the test leads connected to the pipeline to allow verification readings of the cathodic protection system. Internal Corrosion control will be mitigated by utilizing pig runs. Samples will be taken and tested to determine frequency and the need for corrosion inhibitor. Corrosion coupons will be utilized and checked at least Nilo times each calendar year not to exceed 7 1/2 months. 10. Provide a nuisance management plan if applicable (e.g. dairies, feedlots, etc.) Response: Not Applicable 11. Additional information may be requested depending on type of land use requested. Response: Discovery DJ Services, LLC will respond with any additional information required by Weld County. 17 DISC o VERY Proposed Pipeline: Keenesburg PRE1S-0243 Building Questions: 1. List the type, size (square footage), and number of existing and proposed structures. Show and label all existing and proposed structures on the USR drawing. Label the use of the building and the square footage. Response: No building is proposed. The pipeline will exist below grade. The pipeline will have three valve set, above grade, to ensure the safety of the public and environment, and maintainability of the pipeline. . Explain how the existing structures will be used for this USR? Response: Not Applicable 3. List the proposed use(s) of each structure. Response: Not Applicable 1 P DISC MIDSTREAM A VERYDocument PARTNERS Document 1: - Revision #. 1 LO I Revision Date: . 08/08/2018 Name: Decommissioning Plan Location: Abandoned Pipeline(s) and Pipeline Segments) Decommissioning Plan Rips,. yHTFir Abandoned Pipeline Pipelines) Segment(s) and DISC VDocument Document #i Revision #. 11.0 Revision Date: I 08/08/2018 Name: . Decommissioning Plan MIDSTREAM PARTNERS Location: lAbandoned Pipeline(s) and Pipeline Segment(s) TABLE OF CONTENTS Table of Contents wpi44441.44.P.44444f{Mil44444.it+'F5iPinn 44++Iiiit!t'4•4lP444t4+4ttiii4i#44p!144i4444-* Purpose , a... . a a as as ma a a •.a St S 44 .....S.aaa ..a..aa.r..i •e 4tiiiiiiii4•iei•id+ire-iiiiiieii:i 4 4 t 40 4 ry t+ OOOOOOwoe 4 i* *. coa x'•4Wies***FPl.44rtr "s.444sa4aMrafll4alies6oil filgieseti4 lepig!!'tAalliiit4li'4ssPPfintt'!+!!!'41403.i!!iflniit+E9+irPlii4tlYii!4•+iii ielieltreliitiiibbeiali#idMieetiiiaietiter i Definitions i..reraee ai ..• e a .. i .... aI c Responsibility Guidelines sada t, •sr, 4 ,so Document Management Log., ,• •4..t4 seuIli cp a 4'.a aSO404 t.a■p.asalaaap.p4itt4P4+PPPPP4444jpia 4 i+Pioili!tif s •.a.•.ss i a• 2 3 3 3 s3 DISC 6 VERY Document #: Revision N: 11.0 Revision Date: I 08/08/2018 Document Name: Decommissioning Plan Abandoned Pipeline(s) and Pipeline Segment(s) M`i T lr t_ : M P.461114'1 t i4 LiLocation: Purpose Satisfy the Condition of Approval requirements for County review and approval of any/all pipeline(s) and/or pipeline segment(s) that fall subject to Decommissioning Plan. Scope Upon review and approval, this document identifies the minimum acceptable conditions for complying with the referenced Development Standard(s) developed as part of the applicable permitting process. Definitions Company shall mean Discovery DJ Services, LLC, the local operating company of Discovery Midstream Partners LP, their affiliates or successors. Decommissioning shall mean the final state of an underground pipeline facility deemed obsolete and for which abandonment -in -place has occurred. Site Reclamation shall mean soil stabilization in such a manner as to minimize erosion of disturbed areas to the extent practicable, including but not limited to such disturbed areas being built -on, compacted, covered, paved, or provided more than 80% native vegetative cover. Responsibility The Company's Area Pipeline Manager will have the overall responsibility for ensuring plan implementation following the company's decision for pipeline facility abandonment and Decommissioning. Guidelines 1.0 Company Pipeline Decommissioning Plan • The Company will, unless otherwise agreed to or required, ensure the aboveground piping and equipment being abandoned and decommissioned are depressurized, purged, drained and removed from the site. • The Company will, unless otherwise agreed to or required, ensure below grade piping and utilities being abandoned and decommissioned are drained, purged, capped and abandoned in place. • The Company will, unless otherwise agreed to or required, ensure concrete foundations and screw piles being abandoned and decommissioned are cut to grade level and abandoned in place The Company will, unless otherwise agreed to or required, ensure paved sidewalks, roads, and secondary containments being abandoned and decommissioned are removed from the site. • The Company will, unless otherwise agreed to or required, ensure Site Reclamation through the re-establishment of vegetation using native grasses in accordance with local and/or State guidelines. Document #: I Revision 41: 11.0 Revision Date: I 08/08/2018 Document Name: Decommissioning Plan DISC 6v RV MIDSTREAM PARTNERS Location: Abandoned Pipeline(s) and Pipeline Segment(s) Document Management Log AUTHORS This document was prepared by: Name ' Title Compliance Manager Asset Phone Email VERSION HISTORY / CHANGE LOG REVISION RECORD APPROVAL SIGNATURES Version Date Version n Nos Description of Change / Remarks Name of Revising Party ApproverSignature �` Draft Initial Draft and Review N/A N/A 08/23/2018 1.0 Incorporate final edits for application submittal M Norton alyjd 0. 7044L - * ye at r , � [ 7/21/2017 r sin ( �� r Document #: 12 I Revision #: 11 I Revision Date: Document Name: Discovery Emergency Response Plan (DERP) A Location: I Section 2 —Incident Reporting and Management Disc ova in a rg °nay ROB OIL SO Page 1 of 43 1 4 .. `� E` r I Document #: 2.2 I Revision #: I 1 Revision Date: 7/21/2017 e Document Name: Discovery Emergency Response Plan (DERP) Location : - Section 2 —Incident Reporting and Management TABLE OF CONTENTS Purpose of Plan.. M f f444•ff44n•+ DJ Asset Information ■ Incident Response . « a..t.si.* iiYRii•gwru ,!.irwiFYwfi IncidentCommand System............ 1444441444444144444444414144444414 * W I 14444414444114444414441 ft f44 4 1 4 4 M P 1 t 4 M M MP1 4 4 i .i Response iti es.Mt410 Training Requirements of Emergency Responders.12 Drills and. Exercises for Emergencies Y4..,f.i,44440i44 4.Y/..,.Yt1444*Y.4 m 4••. 13 Drill/Exercise After Action Report 14 Media Relations Support Plan.... 15 Incident Reporting • Incident Response ■ 4 . • a c 4 4 v s P a 4 4 444 4 4 4 P Specific Scenario Response 4 4 4 4 4 4 4 4 44 0 4 4 t 44-444 4 4 4 F 4 41444444141014 4i 4 4i 4 4+ 4 4. ■• l.1.' 3 S 17 19 IP. },..+.a i.....Y 4,++...-.44443.4e4.4+.+: '4:.s e++.:.+4+n4..M44}4.444444e 4.4. 4,.;,+.,...4 .' •.e ifit V' Appendix A — Emergency Contact List..36 Appendix Discovery Gas PlantMusterArea apMii44►M/tt441M11444M f44t4MM•tt441 +rer#■4■Ye•rr +■r 37 Appendix C Discovery rD P Muster 7juster Area ea Map. 1i i 1 1 F M M. 4 4 4 Y M M 4 4.4 4 4 M M M 4 4 4 1 1 1 •■ 3 8 Appendix D Accident Analysis -Report Example. 41 MMMf4f 11 tit Y444 LP .444111 i• a+a u• •4■ • 39 Appendix E — Post Injury Treatment Authorization for Preferred Provider Form Example 04fit4iiffa OIL 4 449e42 Appendix F — Employees Notice of Injury Form Example 43 Page 2 of 43 .� (Ai Document #: Revision #: 1 Revision Date: 7/21/2017 2.2 Document Name: Discovery Emergency Response Plan (DERP) Location: Section 2 — Incident Reporting and Management Purpose of Plan The purpose of this Discovery emergency response plan is to establish procedures and responsibilities to all foreseeable emergencies that may occur at Discovery Midstream DJ assets, An emergency is defined as any situation presenting a threat to human life, physical well-being, and company or personal property. The main objectives in any emergency response will be as follows (listed by order of importance): • Protection of personnel and the public • Protection of the environment • Compliance with federal, state, and local laws and regulations • Adhering to safety protocols • Restore normal operating conditions Discovery Midstream works to prevent emergency situations from occurring by implementing and adhering to a culture which values safety and by meeting and exceeding industry best safety practices. Examples include: • Use of all —steel pipe manufactured in the USA for Discovery oil and gas lines • Pipelines buried further underground than standard three (3) feet • Use of thicker, stronger, higher grade pipe than required by standard best practice • Adherence to strict welding standards and 100% X -Ray of all welds • Integration of a rigorous pipeline integrity management program This plan is supported by the Discovery Midstream Leadershipteam. The plan furnishes adequate emergency protection and provides training for the employees, contractors, and visitors at the facility. This plan applies to all employees, contract employees, guests and visitors to the facility during normal office hours, unless otherwise noted below: Employees working outside normal hours will be responsible for carrying out the appropriate actions of this plan{ Pre -Planning During pre -planning it is important to remember that no two emergency incidents are alike. Look at all the possibilities surrounding the emergency. This includes the size of the event, community and environmental impact, and the possibility of several types of emergencies which could occur at the same time. Page 3 of 43 Document #: ,2 I Revision #: 1 J Revision Date: I 7/21/2017 Document Name: .2 Discovery Emergency Response Plan (DERP) r Location: Section 2 — Incident Reporting and Management Site or Area -Specific Planning Measures For all area operations and project work, including testing, construction, commissioning, or maintenance activities, Discovery Midstream personnel will, at a minimum and as applicable to the activities being conducted, initiate a review of the following planning measures: • Clarify project / operational parameters / hazard identification; Conduct risk assessments and implement prevention measures as an integral part of company operations, where appropriate; • Identify the residual risk of the operation, and potential emergency scenarios that could happen; Procure or contract resources to respond effectively to emergencies; • Meet with stakeholders (i.e.: government agencies, residents/landowners, emergency agencies) as required, to discuss emergency planning; • Compile and distribute site -specific emergency response information for the project or production operation to key stakeholders; • Prepare Site Safety / Evacuation Plan(s) for key job sites (i.e. Gas Plants, Occupied Compressor Stations, etc.); • Ensure company personnel and contractors attend emergency response plan review meetings before major facility modifications are commissioned; • Engage corporate support, as required, to ensure emergency support plans address risks and communications specific to the activities; and • Ensure that plans are compliant with applicable government regulation and, if required, registered and/or approved by regulatory agencies. Plan Administration Discovery Midstream personnel are responsible for the development, review and administration of all components of the plan. The administration of Emergency Response Plans and Programs involves the following processes: • Distribution: Copies of programs and plans should be accessible to all Discovery Midstream personnel and agencies assigned responsibilities under the program or plan. Updating: Programs and plans should be reviewed and updated at a minimum once a year (or more frequently as required) to include regulatory changes, organizational and personnel adjustments, identified operational hazards and recommendations resulting from exercises or real incidents. • Approval: Where required, programs and plans should be submitted for regulatory review and approval to the government entity having jurisdiction. Page 4 of 43 Document #: 2.2 I Revision #: )1 'Revision Date: I 7/21/2017 Document Name: Discovery Emergency Response Plan (DERP) Section 2 — incident Reporting and Management 'Location: DJ Asset Information Emergency Planning & Response The Fort Lupton Gas Plant, compressor stations and gathering system have various interlocks, relief valves, and alarms which function to alert personnel and/or protect equipment against processconditions exceeding design parameters. Many of these process safeguards are critical equipment subject to regular testing and preventative maintenance as defined in facility mechanical integrity program. The safeguards prevent emergency conditions from occurring. The Discovery Midstream Gas Plant and compressor stations also have equipment and systems available for personnel to actively respond to an emergency condition. These include: • Facility Emergency Shutdown System (ESD) • Portable Fire Extinguishers placed at required intervals • Fixed Gas Detectors with equipment shutdown capabilities • First Aid Station • Portable Gas Detectors * Smoke Detectors in occupied buildings Discovery Midstream personnel are trained in the use of each to the extent required by authorities having jurisdiction and manufacturer's recommendations. Accountability of Personnel Facility operator will conduct accountability of personnel at muster areas utilizing facility sign -in sheet. Equipment Shutdown Operations Department will be responsible for shutting down procedures. Incident Communication - Radio Use Two (2) -way radios will be utilized as the primary communication devices in the event of an incident. Cellular (cell) phones will be utilized in the event radios are not transmitting/receiving communications. Location of Discovery Operation Center (DOC) The Discovery Operation Center is located at 4501 Weld County Road 35 Fort Lupton, CO 80621. Ideally, the Operations Center should be equipped with a radio base, several phone lines, and be centrally located for personnel to be dispatched from. Page 5 of 43 rinr44iilits r Document #: 2.2 I Revision #: I 1 � Revision��iRevision�te; Date:�ocu 7/21/2017 Discovery Emergency Response Plan (DERP ) Document Name: Location: Section 2 — Incident Reporting and Management Incident Response Incident Levels Discovery Midstream incorporates three incident levels as part of the "Incident Notification Procedure," (ref. Document 2.1, Incident Notification.) The Incident Notification Procedure assures an incident is promptly addressed at appropriate level to provide resources and support to control and mitigate incident. Implementation of a three tier system helps ensure notification of State and Federal agencies (as applicable), while enabling Discovery Midstream to evaluate impact of incident on employees, general public, and customers. In order to properly respond to any emergency, incidents should be classified into one of three levels. The incident level is determined by complexity of the incident, risks to company personnel and public, and impact on the environment. The three level classifications will be used and communicated to all personnel within the company. Level 11 Incident The most serious and highest level incident. Level 1 incidents are usually on going and typically involve at least one of the following: a. Any fatality b. Event requires support of government or Emergency Responder agencies c. A non -incipient fire, rupture or explosion involving a Discovery Facility that requires assistance from Emergency Responders d. Any media attention at a Discovery Incident e. Results in more than $100,000 in estimated Property damage *A Level 1 Incident will automatically activate the Corporate Emergency Support Team and Emergency Operations Center. Notification Protocol: a. Immediately notify local Supervision, Discovery Operations Center (DOC), Director of Operations, COO b. Discovery Operations Center (DOC) will activate Discovery local First Responder(s) and local city/county fire/emergency organization if needed. c. Discovery Operations Center (DOC) will telephone local city/county officials, landowners and/or local citizens if off -site impact. d. Discovery Operations Center (DOC) will communicate (text, email or phone call) all Corporate Personnel as appropriate. Page 6 of 43 A . 2.2 Revision #: 1 Revision Date: 7/21/2017 Document #: Discovery Emergency Response Plan (DERP) Document Name: Location: k Section 2 —Incident Reporting and Management Level 2 Incident An event of moderate impact, usually controllable from the scene. Level 2 incidents may be ongoing and typically involve at least one of the following: a, Any Discovery spill/'release from a Discovery pipeline or facility b. Any land slip or "frac out" that impacts a water way or has the potential to impact a water way c. Estimated damage or penalties in excess of $50,000 but less than $100,000 d. An incipient fire involving injury or damage to Discovery Facilities e. Emergency Responder attention f. Motor Vehicle Accident ("MVA") with employee or third party injuries g. A security risk that poses a threat to the Company or the Public Notification Protocol: a. Notify local Supervision, Discovery Operations Center (DOC), and local Safety/Environmental Representatives. b. Discovery Operations Center (DOC) will telephone local fire/emergency organization(s) if needed and complete preliminary incident report (PIR) in the ISR. c. Discovery Operations Center (DOC), Local Manager or Designee will communicate (text, email or phone call) to all personnel as appropriate. Level 3 Incident Relatively minor event involving one of the following characteristics: a. Injury, Illness that requires onsite or offsite First Aid Treatment b. "Good Catch" Reporting c. Land slips that do not affect water ways or have the potential to affect water ways. d. Estimated property damage is not expected to exceed $50,000 e. No media or emergency responder attention f. Event that significantly disrupts operations or deliveries (commercial business impact only) g. Near Miss Reporting h. MVA with no employee or third party injuries Notification Protocol: a. Notify local Supervision b. Local Manager or Designee will communicate (text, email or phone call) to all personnel as appropriate. Page 7 of 43 1 1 Revision Date: 7/21/2017 Document #: 242 Revision #: J A Document Name; Discovery Emergency Response Plan (DERP) Location: Section 2 — Incident Reporting and Management Incident Command System Discovery Midstream follows an Incident Command System (ICS) structure when responding to any incident. While most incidents are small enough that only limited incident command will be required, larger incidents may require a full-scale ICS. The ICS is designed to enable effective and efficient incident management by: • Integrating a combination of facilities, equipment, personnel, etc. within a common organizational structure Enabling response measures to be scaled according to nature and size of incident • Involving only those functions required for level of response (i4e. operations, finance, public relations) • Allowing one person to take charge of incident for the company and determine size of response required • Merging into and working with ICS of responding agencies (most governmental agencies use an ICS) Discovery ICS matrices for Level 1, Level 2, and Level 3 incidents are provided. The formats are for full-scale ICS, while normally only a portion of the ICS will be required. For Level 1 and Level 2 incidents, personnel will assume responsibility for primary duties in ICS. One person may assume various or all responsibilities for Level 3 incidents, The ICS structure is meant to be flexible. The Incident Commander is responsible for establishing the size and strength of the team. Primary jobs are: • Incident Commander • Director of Operations (Incident Response Leader) • Operations Lead (Logistics — Calls contractors and field assistance) •► Manager of Engineering (Planning — Decides on response strategies/schedules events) • Chief Operating Officer (Executive Lead) • Finance Office (Receives invoices, approves and signs) • Media Relations Officer (Interacts with media, community, etc.) *Note -- First on -scene employee is the incident commander until other employees or agency responders arrive with increased training and experience in handling type of incident. Page 8 of 43 Document #: 1.2 I Revision #: 11 [Revision Date: 7/21/2017 E A Document Name: Discovery Emergency Response Plan (DEW') Section 2 -- Incident Reporting and Management Location: Discovery ICS Matrix Level 1 Incident Commander Operations Lead Manager of Engineering Discovery Operations Center Director of Operations Chief Operating Officer Safety First Responders: - Fire Dept, - Police - Medical Finance Media Relations Environmental Level 2 Incident Commander Safety Operations Lead Discovery Operations Center First Responders: - Fire Dept. - Police - Medical Manager of Engineering Environmental Level Incident Commander Operations Lead Page 9 of 43 Document 4*: 2.2 Revision #: 1 I Revision Date: I 7/21/2017 A Document Name: Location: Discovery Midstream Leadership Discovery Emergency Response Plan (DERP) Section 2 -- Incident Reporting and Management Responsibilities Discovery Midstream Leadership includes the Director of Operations and Management ement that is part of the leadership team for the facility. Discovery Leadership is responsible for: 1. Identifying and designating the persons) responsible for developing the DERP for their areas of responsibility .d ensuring the DERP is developed in compliance with Discovery Midstream standards and any additional emergency response plan governmental regulations. 2. Communication of the DER' to all employees and contractors in their areas of responsibility. 3. Ensuring employees complete required training. 4. Ensuring employees in their areas participate in drills and exercises. Emergency Action Committee The Emergency Action Plan Committee consists of Discovery Leadership, Media Relations, Health & Safety, and Environmental representatives, The Committee is responsible for: 1. Review and revision of this plan. Scheduling emergency response drills. Discovery Operations Center (DOC) The Discovery Operations Center is responsible for: 1. Routing emergency calls to appropriate personnel identified in the Emergency Contact list provided according to incident level. 2. Gathering information to communicate to Director of Operations or designated Incident Commanders and/or external emergency responders. Operations Department The Operations department is responsible for: : 1. . Enacting and completing shut -down procedures for the facility. Safety and H e a lth Department The Safety and Health representatives are responsible for: 1. Identifying, providing, or obtaining appropriate Emergency Response training for all employees. 2. Maintaining and updating written Emergency Response Plan per Discovery Leadership, 3. Coordinating Emergency Response drills with Discovery Leadership. Page 10 of 43 I A Document #: 1 i Revision Data: 242 Revision #: I 7/21/2017 Document Name; Discovery Emergency Response Plan (DERP) Location: Section 2 — Incident Reporting and Management Supervisors Supervisors are responsible for: 1. Ensuring their employees are aware of the steps to take in an emergency. . Notifying DOC of the location of mobility impaired employees who will require evacuation assistance if a building evacuation is ordered. . Ensuring employees in their area of work responsibility are trained on the Discovery Emergency Response Plan. Employees Bach employee: 1. Is responsible for their own safe evacuation during emergencies and drills. . Is required to participate in practice drills and respond to all emergency alarms. 3. Is required to obtain training over the Discovery Emergency Response Plan. 4. Is responsible for escorting their visitors to an exit or safe area during an emergency or drills. Mobility Impaired Employees Mobility impaired employees are responsible for: 1. Informing their supervisors and Evacuation Warden that they will require assistance during a building evacuation. 2. Positioning near an emergency exit to await evacuation assistance from the Fire Department if a building evacuation is ordered. Page 11 of 43 A Document #: 2.2 I Revision #: I 1 Revision Date: 1 7/21/2017 Discovery Emergency Response Plan (DERP) Document Name: Location: Section 2 — Incident Reporting and Management Training Requirements of Emergency Responders Training for emergency response employees shall be completed before employees are called upon to perform during real emergencies. Such training shall include the elements of the emergency response plan, standard operating procedures the employer has established for the job, the personal protective equipment to be worn and procedures for handling emergency incidents. Training requirements for emergency responders per OSHA 9 CFR 1910,120(q) are: Action Training First Responder Awareness Sufficient training to demonstrate Level: competencies. Initiating Emergency Response Only: Notifying authorities First Responder Eight (8) hours of Operations Level: training and specified l Protect envirorunent espo nearb l in frond Defensive persons, safe prop+er1t distance. ashion , or competencies. Respori in an ►ggressi a Fasl ion: Hazardous Materials (HAZMAT) Technician: Twenty Responder competencies. four (24) hour of training equal to First Operations Level and specified ' Hot Zone ppro ach point releas ntr to plug of`release stop ng, hazardous patching, or exposure.) substance or calve release isolation i.e. at point .ssume Incident ontrol oinnianders o Incident: assume control of the on Scene Incident Commander: Twenty four (24) hours of Responder Operations Level competencies. training equal to First and specified incident aren+ess scene Feel. be on first Responder Skilled Support: Skilled Support Personnel: Initial briefing at emergency response site to include wearing of PPE, chemical hazards involved, and duties to be performed. Provides immediate, short-term support at scene of incident, work Specialized Support: assist, counsel, hazardous substances or advises IC on specific at the facility, Specialist Employees: Sufficient training or demonstration competency in area of specialization annually. Clean 40 -hour training Plans), 1910.1200 applicable necessary -Up or HAZWOPER in 29 1910.134 (Hazard safety by Clean -Up Supervisors: training, CFR 1910.38 (Respiratory Communication), and health tasks expected plus proper (Emergency Action Protection), and other training made to be performed. Clean -Up or Clean -Up Supervisors: Assisting with or directing clean-up efforts on plant property. Page 12 of 43 2.2 Revision #: 11 I Revision Date: 7/21/2017 i ; ,` iA ; I I i} / Document #: Document Name: Discovery Emergency Response Plan (DERP) Location: Section 2 — Incident Reporting and Management Drills and Exercises for Emergencies Discovery Midstream training exercises or drills for emergencies and frequency for each for the Fort Lupton, CO Gas Plant are described. The purpose of any exercise or drill is to reveal planning weaknesses, reveal resource needs and shortfalls, improve coordination within the site, clarify roles and responsibilities, and improve overall performance of all employees. 1. Drills or Exercises will be carried out atleast once every 12 months or more frequent if needed or required by Discovery Midstream Operations. 2. Table Top Exercises — When chosen this type of exercise is best utilized to resolve coordination and responsibility issues through a low stress discussion. 3. Functional Exercises — When chosen this type of exercise simulates a real emergency under high stress conditions by testing coordination among various functions and outside response agencies. 4. Full Scale Exercises — When chosen this type of exercise test an entire community's response capability and involves the use or real world equipment. 5 Any three of the exercise types are acceptable for testing the functionality of this ERP. 6. When conducting a drill, an "After Action Report" needs to be completed and documented identifying at a minimum the following: • Type of drill/exercise conducted • Scope and Objectives Persons involved • Sequence of events • Results/Outcome (i.e. Were objectives achieved) • Lessons learned • Action plan, including timelines Page 13 of 43 i'A 1 Revision it: Ji. I Revision Date: I 7/21/2017 Document if: 2.2 Document Name: Discovery Emergency Plan (DERP) Response Location: Section 2 — Incident Reporting and Management Drill/Exercise After Action Report Drill/Exercise Type: Scope & Objective: Date & Time: Facility: _ Participating Agency: Location Alarm Initiated: Yes No N/A COMMENTS/ACTIONS EVALUATION CRITERIA Communication Process a. Was Emergency Shutdown (ED) audible throughout facility? ❑ ❑ ❑ b. Are communication tools adequate (phones, other equip)? ❑ ❑ ❑ c. Are lines of communication clearly understood? ❑ ■ ■ Decision -Making Process and Authority a, Were decisions made in a timely and effective manner? ■' ❑ ❑ b. Are changes necessary to improve decision -making process? ■ ❑ ERP Understanding a. Does everyone understand the Incident Command Structure how it differs from daily operations? an - ❑ b, Was re activation onse executed properly contacts receive timely and did proper emergency notification of incident? ■ ■ ❑ c. Didemployees know locations of and assemble at primary or second s muster area? ❑ ■ d. Was accountability for all personnel at the plant taken? N ❑ ■ Media Response a. Was media handled in an appropriate manner? ❑ ❑ ■ b. Was media response pro -active and timely? ■ ■ ❑ c. Was follow-up to media appropriate and timely? ❑ ❑ I ❑ Crisis Management Ability a. Were critical issues identified and addressed? ❑ ❑ ❑ b. Were facilities adequate for level of emergency response? ❑ I ❑ ❑ c. Was overall team effort effective in handling the incident? ❑ ❑ ❑ Document Performance ❑ a. Was information needed to assess scenario readily available? ❑ ■ Notification Performance a. Were internal manner? notifications made in a timely and effective ■ _ ❑ b. Were agency notifications made in a timely and effective manner? ❑ ■ Overall Effectiveness of Emer enc Res . i nse Plan a. Were objectives of drill/exercise achieved? ■ ❑ ❑ , Comments/Concerns/Corrective Actions: Review and Sign -Off by: Print Name: Page 14 of 43 Document #: 2,2 Revision #: 1 Revision Date: 7/21/2017 ,v. Document Name: Discovery Emergency Response Nan (DERP) Location: Section 2 — Incident Reporting and Management Media Relations Support Plan In the event of an emergency involving or potentially involving the news media (TV, radio, newspaper, etc.), Discovery Midstream will utilize a representative from the Teri' 10 Group whose name and phone number is listed on the Emergency Contact List in Appendix A. The Ten/l. 0 representative will be responsible for developing, managing, and communicating essential organization information to internal and external stakeholders with the assistance of Discovery Management team. Thiscould include: • • Maintaining proactive contact with Emergency Response Team(s), assisting with evaluations, collecting information, and communicating progress and updates; Liaising with community relations and field personnel; • Developing and distributing public statements and news releases; • Arranging and leading media communications when necessary. In the event members of the news media approach you for comment on any Discovery Midstream emergency situation, tell them a statement is being prepared, and defer any further comments to Director of Operations or other senior manager when Director of Operations is not available. Keep in mind the news media are the company' s liaison with the public and the community. They must be treated fairly, with every effort made to cooperate honestly. If a member of the media wants on -the -spot coverage or personal interviews, the following applies: 1. Notify the senior manager on site. 2. Senior manager shall call Discovery Midstream Media Relations Contractor at (303) 507- 0510. 3. Media Relations Contractor will gather facts of the situation, prepare a statement, coordinate with client as required and return site contacts call to provide instruction. Under no circumstances will the name of any accident victim be released to the public, when the facts become known, a Senior Company employee will, in conjunction with Media Relations Contractor and Executive team, prepare a statement for release to the news media, if appropriate. Media Management "Do" and "Do Not" Do • • Exhibit a professional, co-operative but firm attitude and remain low-key at all times. • Know the location and telephone numbers of company spokespersons. Know the whereabouts of all media in your party at all times. Offer to follow up requests for information about the incident, rather than answer questions yourself. Page 15 of 43 u1 Document #; 2.2 !Revision #: 11 I Revision Date: - 7/21/2017 40 b 4.)1 r" - Document Name; Discovery Emergency Response Plan (DERP) Location: Section 2 -- Incident Reporting and Management Don't • Don't try to please photographers by allowing unauthorized photo opportunities. • Don't allow media in "No go" areas. If theinsist, request back up. • Don't feel compelled to answer questions. You are not a spokesperson. "I don't know" is a good answer. • Don't get into a confrontation with the media. It may become the story. * Remember any statements made by company employees' and/ or contractors that may in any way deal with root cause, fault or liability have the potential to negatively impact the corporate reputation. Page 16 of 43 Document #: 2�,fr, Revision ia� I #: I � I Q v on Revision Date: 7/21/2017 r Document Name: Discovery Emergency Response Plan (D ER P) L Location: Section 2 — incident Reporting and Management Incident Reporting 1.0 Application 1.1 Applies to all Discovery Midstream employees. 2.0 Defmitions Environmental Incident -- incidents with potential to adversely affect environment or violate environmental law or permit. Fatality — any work related death while engaged in Discovery Midstream business. This does not include death while traveling to and from work. First Aid — One time treatment and subsequent observation of minor injuries when those and only those treatments are administered and mentioned as First Aid per OSHA (See OSHA 29 CFR 1904.7(b)(5)00(A) through 1904.7(b)(5)00(N) for what OSHA considers First Aid.) Illnesses — An abnormal condition or disorder caused from anything other than Instantaneous events. This includes acute illnesses resulting from relatively short exposure times. Illnesses may be caused in whole or in part, by exposures to chemicals, physical agents (e.g. radiation, noise, extreme temperatures), biological agents, and ergonomic factors. Incident -- Any event which causes or has potential (Near Miss) to cause personal injury, da age'loss of assets, environmental damage or hazard to health and/or safety of any individual. Injury — An abnormal condition or disorder caused by instantaneous events such as cuts, slips, falls, etc. Near Miss -- Any incident where the potential for personal injury, property damage, or adverse environmental impact was present due to an event which occurred, even though there was no injury, damage, or impact due to timing or distances Stop Work — Authority and responsibility provided to all Discovery Midstream employees, contractors, and visitors to intervene or stop a task without fear of reprisal if any unsafe action or condition at the work site is observed. Vehicle Incident — Event or occurrence involving vehicle owned, operated, assigned, controlled, rented or leased by Discovery Midstream, including personal vehicles while being used for company business or subsidized by company. Work Related Injury of Illness- Injury or illness if an event or exposure in the work environment either caused or contributed to the resulting condition or significantly aggravated a pre-existing injury or illness. Page 17 of 43 ,iA ': ' P E i 4 - f Document #: 2.2 Revision #: J. Revision Date: 7/21/2017 Document Name: Discovery Emergency Response Plan (DERP) Location: Section 2 — Incident Reporting and Management 3.0 Work -Related Injuries, Illnesses and General Incident Reporting Requirements 3.1 The following must be reported to Discovery Midstream Management for classification, input, and investigation within 24 hours of occurrence: Work -Related Injury or Illness • Reportable Environmental Incidents • Property and Equipment Incidents • Near Misses Any other occurrences deemed necessary by Discovery Management 3.2 Discovery Midstream utilizes a third party company, "Employer Flexible" to manage the company's workers Compensation Claims Program and Post Injury Support. 3.3 When any of the incidents mentioned in section 3.3. occur, the supervisor or lead person in charge shall complete the following: 3.3.1 Fill out and complete an Accident -Analysis Report (Appendix D) within. 24 hours of the occurrence and send to Discovery Midstream Management, Safety Department, and Employer Flexible. 3.4 Any incident requiring an employee to seek medical attention, will also require employee, supervisor, or lead person in chard to complete the following: 3.4.1 Fill out and complete the "Post Injury Treatment Authorization for Preferred Provider Networks" form (Appendix E) and emailed copy to risk j mpIoyeri�lexib1e.coni or call "Employer Flexible Safe & Risk Main Line at 1-888-983-5881 to speak with live person. 3.4.2 The employee shall carry the completed form with them to the attending clinic/hospital. 3.4.3 The employee shall complete the "Employees Notice of Injury" form (Appendix F) after being treated and when able to do so. 3.4.4 The completed form will be faxed to Employer Flexible at 281-377-7029. 3.5 All incidents mentioned in section 3.1. will be investigated by a team of Discovery Midstream employees and EHS department. Page 18 of 43 Document #: 1 Revision #: 7/21/2017 242 I 1 1 Revision Date: 1 Document Name: Discovery Emergency Response Plan (DERP) Section 2 — Incident Reporting and Management Location: Incident Response General Actions The first person at the scene of an emergency may be faced with a complex situation. A "First Responder" should try to remain calm, exercise decisiveness, and provide assurance. A First Responder should take the following steps and improvise as needed: 1. Scan surroundings to ensure own safety and safety of those who may enter area. A general assessment of situation will help clarify actions required. If person(s) with injuries are present, contact appropriate emergency services (if necessary) and if comfortable, voluntarily treat injured person(s) to best of your training and abilities: 2. Evacuate people in immediate danger or with injuries if comfortable and if moement will not cause further harm. If willing, administer first aid, if necessary, per training. Arrange for traffic control as required. Be firm, explicit, and courteous with the public. Exert positive leadership and give instructions calmly. 3. Isolate and eliminate any sources of ignition, such as running engines, sources of sparks, etc. Check road crossings, public utilities, and overhead power lines for danger from possible fire. Shut down operations as needed. 4. Open or close valves as necessary, if it can be done safely, to eliminate the flow of gas to the affected area. 5. Contact your supervisor and Discovery Midstream Operations Center and give a brief overview of the incident and your actions. Based on Level of incident will determine emergency response plan going forward. 6. Maintain scene control until relieved by a supervisor or more experienced person. Use whatever actions necessary to safeguard all persons, property, and environment only when actions can be accomplished in a safe manner. Page 19 of 43 Document #: 2.2 Revision #: 1 I Revision Date: 7/21/2017 Document Name; Discovery Emergency Response Plan (DERP) i 1 Location: Section 2 --Incident Reporting and Management Specific Scenario Response The following specific events are considered pre -emergency guidelines. General Fire/Explosion/Wildfire 1. Activate facility or system shutdown. 2. Perform continuous monitoring and notify Discovery Operations Center 877-614-7183 or Fire Department 911. 3. If, and only if, fire is in incipient stage, personnel who have been trained in the use of portable fire extinguishers may attempt to extinguish fire using these devices. 4. If decision is made to use portable fire extinguisher, an evacuation of the area or building should commence in conjunction with these efforts. 5. In the event of a fire or explosion, personnel shall evacuate the facility. 6. If willing and trained, provide first aid to any injured persons. 7. Request emergency medical services (if needed). 8. If safe to do so, clear area of any persons, vehicles, etc. which may be affected by the emergency. 9. Request additional resources if needed (fire, police, or company personnel) to isolate area. 10. Evacuate using nearest and safest "Exit". 11. Proceed to your Designated Muster Area. 12. Do not return to the building/area until "All Clear" is given by Operations Department. artment. Hazardous Material Spill 1. Perform continuous monitoring and notify your supervisor of the situation. 2. Take actions necessary to prevent the contamination of additional personnel and/or additional area or property. . Place barricades to restrict access. 4. Evacuate personnel from area. 5. User personal protective equipment to prevent contamination, 6. Provide first aid if needed. 7. Call additional resources if needed (fire department, emergency medical services, etc,). Tornados / High Winds 1. Perform continuous monitoring of the situation by contacting the National Weather Service, listening to radio, television and/or communicating with your supervisor. 2. When a tornado warning is issued, ensure that employees in the affected area are notified of the warning. 3. Determine what facilities, if any, should be shut in. 4. Determine where personnel should be "stationed". 5. Determine if vehicle traffic should be restricted. Page 20 of 43 r is r . - # • A ' '1 e' P Document #: Revision #: ft I Revision Date: I 7/21/2017 2 2 1 Discovery Emergency Response Plan {DERN Document Name: Location: Section 2 incident Reporting and Management — 6. Determine expected duration of the emergency. 7. Determine if personnel will be dismissed until normal operations are possible. 8. Determine if an alternate interim worksite / office will be used. 9. Address concerns for affected personnel (others in areas of the incident). 10. Rave location personnel report to the designated area. 11. Account for all personnel on duty. 12. Be aware of your surroundings. 13. If your facility is damaged by the tornado / high wind, notify your supervisor. Winter Weather (Severe snowstorm, blizzards and ' or freezing temperatures) 1. Perform continuous monitoring of the situation by contacting the National Weather Service, listening to radio, television and/or communicating with your supervisor. 2. Avoid unnecessary travel. 3. Understand the hazards of wind chill which combines the cooling effects of wind and cold temperatures on exposed skin. 4. Blizzard warning include strong winds, blinding wind driven snow and dangerous wind chills. 5. Seek shelter immediately, if needed, and stay in contact with your supervisor, Pipelines Explosion or Fire near a Pipeline 1. Determine is a 911 call is needed. 2. Offer first aid to any injured parties. If the incident is reported by an outside person, the Field Supervisor shall be contacted immediately. The field supervisor or his designee will alert the Operations Manager in order to maximize response and ensure the safety of others working in the area. The Operations Manager will dispatch the Incident Commander and the closest Field Operator, team member, or authorized designee in the area to the site reported and attempt to identify the source of the fire or explosion. If a fire is present, the gas supply shall be shut in immediately, followed by isolation at the nearest block valves on either side of the site. Unless there is immediate danger to nearby personnel or equipment, the fire should be allowed to bum out on its own, unless the decision is made to extinguish the fire. 1. The First Responder / Operator shall: a. Monitor line pressure at delivery and receipt points and station sites. b. Close isolation valves to stop the supply of gas to the affected area. c. Ensure that no other persons enter the scene until it is determined to be safe by the Operations Manager or his designee. Page 21 of 43 Document it: 12 2 Revision it: 11 I Revision Date: 7/21/2017 r t Document Name: I Discovery Emergency Response Plan (DERP) Location: I Section 2 — Incident Reporting and Management 2. The Incident Commander Field Supervisor shall: a. Travel to the scene and assume the Incident Commander role. b. Provide assistance in the event of an evacuation. c. Assist the Pipeline Operator or authorized designee with the preparation of a log of incident events and scene photo graphs . 3. The Communications Center / Operations Manager shall: a. Determine the need for notification of: i. Public utilities. ii. Additional team members if additional lines are to be shut in. iii. Corporate personnel. iv. Regulatory agenci es . 4. Site Security a. Once the source of the gas has been shut off and the fire extinguished, the area shall be kept clear of all personnel. Once the area is determined by the Operations Manager to be safe for entry by Discovery personnel, an investigation willbegin. b. Once the area has been determined by the Operations Manager to be safe for long term entry by Discover personnel and contractors, work may begin on repairing the pipeline. 5. Returning to Service a. Upon completion of the repairs, the line shout be refilled at a rate that will ensure complete evacuation of any air within the line. The amount of time for purging will depend on the pressure used to purge, the location of the repair, and the amount or air allowed into the pipeline during repair. Purging shall be conducted in accordance with the Purging Procedures in the Discovery Midstream Gas Pipeline System Operations and Maintenance Manual. (Reference Gas O&M 1501) 6. Investigation a. Once the initial investigation criteria has been met, and the area has been approved to be returned to operation, a thorough investigation of the cause of the incident shall be made and action taken shall be reviewed to ensure the effectiveness and continuity of the plan. Changes deemed necessary should be implemented as quickly as possible. Pipeline Leak / Unexplained Gas Loss 1. Initial Response for a Pipeline Leak: a. The initial response to any leak in the pipeline shall be to dispatch the nearest Pipeline Operator, employee team member or authorized designee to the site reported and to search the area reported for the source of the leaking gas. Responders should be aware of wind direction and low lying areas where product may settle and the respective hazards of each. In no case, will any person approach an area exceeding 10% LEL. b. Once the source of the gas leak has been located, the area shall be kept clear of all personnel other than those of the Company or of a Contractor. Once the area is Page 22 of 43 L �` R 1 (A k '. _ . 1 t i Document #: 2.2 Revision Ta 11 I Revision Date: 7/21/2017 f,. Document Darns: Discovery Emergency Response Plan (DERP) Location: Section 2— Incident Reporting and Management - secured, the leak shall be stopped by suitable means (i.e., Shut down compressors or isolate the leak through the use of block valves). 2. Initial Response for an Unexplained Gas Loss: a. The initial response shall be to dispatch an operations employee to the site suspected to search the area for the source of the leaking gas. b. If there is difficulty locating a suspected leak, the following steps shall be implemented: i. Shut down the line in question under pressure and watch for a pressure drop. Close intermediate valves to isolate leaking section. ii. Look for signs of damage to vegetation, wilted leaves, etc. iii. Use a probe bar to make holes above the line, taking care not to hit the line itself, and sniff the holes with a leak detector. iv. Using detection equipment, inspect the open end of casing vents. v. Obtain more sensitive equipment to perform a flame -ionization survey. vi. If required, shut down and isolate the line into sections and determine which section is not holding pressure. See the Discover Pipeline tactical Plan for valve locations. 3. Action to be taken a. Determine if a 911 call is needed. If the leak is in the pipe itself, and is escaping from a small hole or pit, the leak may be stopped with a repair clamp. b. After this temporary repair has been made, the line should be permanently repaired when conditions are safe to do so. If corrosion is suspected, a survey of the immediate area should be made to check the effectiveness of the cathodic protection in the area. c. If the leak is too large for a temporary repair, the system should be shut down, isolated from the stations, and the nearest isolation valves closed. The affected segment of line should then be blown down to atmospheric pressure and repairs made by qualified and approved personnel. 4. Returning to Service a. The amount of time required for purging will depend on the pressure used to purge, the location of the repair along the line, and the amount of air allowed into the line during the repair procedure. As each incident may contain unique elements, a plan for returning to service will be prepared for each incident, in accordance with the Purging Procedures in the Discovery Midstream Pipeline System Operations and Maintenance Manual (reference Gas O&M 1501). b. After the line is back in operation, athorough investigation of the cause of the leak shall be made and action taken to prevent a re -occurrence. This may entail sending a specimen of the pipe from the leak site to an independent laboratory for examination, if the leak was due to failure of the pipe, a weld failure, or corrosion. If the leak was caused by third party damage, analysis may not be necessary. 5. The Pipeline Operator, employee team member, or authorized designee shall: a. Monitor line pressure at delivery and receipt points and station sites. b. Open or close isolation valves as necessary to stop the supply of gas to the affected area. Page 23 of 43 12 Revision #: 11 Revision Date: 7/21/2017 Document if; Discovery Emergency Response Plan (D ER E) Document Name; Section 2 - Incident Reporting and Management Location: c. Alert Company and approved Contractor personnel and dispatch necessary personnel, equipment, and material to the scene. d. Ensure that no persons enter the scene until determined safe by the Operations Manager or his designee. 6. The Field Supervisor shall: a, Alert Company and Contractor personnel to ensure the safety of those who may be working along the same system. Dispatch necessary personnel, equipment, and material to the scene. b. Arrange assistance for persons in the event any evacuation is required. c. Establish and maintain communications with the Pipeline Operator on site. d. Repair the line and restore service as soon as possible. e. Assist the Pipeline Operator, employee team member or authorized designee with the preparation of a log of incident events and scene photographs. 7. The Operations Manager or their designee shall determine the need for notification of: a. Public utilities. b. Additional employee team members or other company personnel if additional lines are to be shut in. c. Regulatory agencies for incident reporting. Suspected Damage Due to Natural Disaster near Pipeline 1. Action to be taken a. Following any natural disaster capable of causing damage to the pipeline or pipeline facility, an immediate check of the pipeline and pipeline facility for any unexplainable pressure loss, gas vapor or gas odor shall be conducted by the a designated Pipeline Operator, team member or authorized designee. b. In addition, personnel shall make a patrol of the entire pipeline route if the natural disaster has been of the magnitude sufficient to cause any local structural damage. c. If any leaking gas is found, the area shall immediately be cleared of all personnel other than those of the Company or of a designated contractor. Once the area is secured, the leak shall be stopped by suitable means. d, The Field Supervisor or his designee will alert other company personnel as needed in order to maximize response and ensure safety for others working along the same system. e. If the leak is in the pipe itself, and is escaping from a small hole or pit, the leak may be stopped with a repair clamp. After this temporary repair has been made, the line should be permanently repaired when conditions are safe to do so. If corrosion is suspected, a survey of the immediate area should be made to check the effectiveness of the cathodic protection in the area. f, If the leak is too large for a temporary repair, the system should be shut down, isolated from the stations, and the nearest block valves closed. The affected segment of line should then be blown down to atmospheric pressure and repairs made by a qualified contractor. , Return to Service Page 24 of 43 A Document #: W 2.2 Revision #: I 1 Revision Date: 7/21/2012 Document Name: Discovery Emergency Response Plan (DERP) r Location: Section 2 — Incident Reporting and Management a. The amatmt of time required for purging will depend on the pressure used to purge, the location of the repair along the line, and the amount of air allowed into the line during the repair procedure. As each incident may contain unique elements, a plan for returning to service will be prepared for each incident, in accordance with the Purging Procedures in the Discovery 'Iidstream Gas Pipeline System Operations and Maintenance l anual. (Reference Gas O&M 15 01) 3. Investigation a. Once the initial investigation criteria have been met, and the area has been approved to be returned to operation by 'tanagement, a thorough review of the incident and the responses made shall be conducted. Compressors Explosion or Fire at a Compressor Station 1. Determine is a 911 call is needed. I Offer first aid to any injured parties. If the incident is reported by an outside person, the Field Supervisor shall be contacted immediately. The field supervisor or his designee will alert the Operations Manager in order to maximize response and ensure the safety of others working in the area. The Operations Manager will dispatch the Incident Commander and the closest Field Operator, team member, or authorized designee in the area to the site reported and attempt to identify the source of the fire or explosion. If a fire is present, the gas supply shall be shut in immediately, followed by isolation at the nearest block valves on either side of the station. Unless there is immediate danger to nearby personnel or equipment, the fire should be allowed to burn out on its own, unless the decision is made to extinguish the fire. 1. The First Responder I Operator shall: a. Monitor line pressure at delivery and receipt points and station sites. b. Close isolation valves to stop the supply of gas to the station. c. Ensure that no other persons enter the scene until it is determined to be safe by the Operations Manager or his designee. 2. The Incident Commander ' Field Supervisor shall: a. Travel to the scene and assume the Incident Commander role. b. Provide assistance in the event of an evacuation. e. Assist the Pipeline Operator or authorized designee with the preparation of a log of incident events and scene photographs. . The Communications Center / Operations Manager shall: a. Determine the need for notification of: i. Public utilities. ii. Additional team members if additional lines are to be shut in. .. in. Corporate personnel. iv. Regulatory agencies. Page 25 of 43 A Document #: 4 12 I Revision #: Ii Revision Date: 7/21/2017 Document Name: Discovery Emergency Response Plan (DERP) Location: Section 2 — Incident Reporting and Management p R � 4. Site Security a. Once the source of the gas has been shut off and the fire extinguished, the station shall be kept clear of all personnel. Once the area is determined by the Operations Manager to be safe for entry by Discovery personnel, an investigation will begin. b. Once the station has been determined by the Operations Manager to be safe for long term entry by Discover personnel and contractors, work may begin on repairing the station. 5. Returning to Service a. Upon completion of the repairs, the line shout be refilled at a rate that will ensure complete evacuation of any air within the line. The amount of time for purging will depend on the pressure used to purge, the location of the repair, and the amount or air allowed into the pipeline during repair. Purging shall be conducted in accordance with the Purging Procedures in the Discovery Midstream Gas Pipeline System Operations and Maintenance Manual.(Reference eference Gas O&M 1501) 6. Investigation a. Once the initial investigation criteria has been met, and the area has been approved to be returned to operation, a thorough investigation of the cause of the incident shall be made and action taken shall be reviewed to ensure the effectiveness and continuity of the plan, Changes deemed necessary should be implemented as quickly as possible. Plant Explosion or Fire at a Plant 1. Determine if a 911 call is needed. 2. Offer first aid to any injured parties. The Lead Plant Operator shall be contacted immediately. The Lead Plant Operator will assume the role of the Communications Center and will alert other company personnel as needed in order to maximize response and ensure safety for others working along the same system. Upon activation of the Emergency Shut Down (BSI) protocol, all personnel must report to the pre -determined location for a head count outside of the plant. This head count will be completed by the Incident Commander, or Plant Operator. Log entries of visitors will be utilized to account for all persons inside the plant. Visitors will receive training about alarms and mustering areas. Plant personnel should notify any adjacent operations of the current situation so they can act accordingly with regard to their own operations and the potential effect on our operations. The Lead Plant Operator or his designee should consider the effect of both shut down and continued operations of adjacent facilities. Page 26 of 43 Document #: 12 Revision #: 11 1 Revision Date: , 7/21/2017 Document Name: Discovery Emergency Response Plan (DER!) A , Location: Section 2 —Incident Reporting and Management Once the fire department and/or Lead Plant Operator has verified that it is safe for you to enter, employee team members may return to secure the plant and attempt to identify the source of the explosion/fire. 1. The First Responder / Plant Operator shall: a. Open orclose isolation valves as necessary to stop the supply of gas to the affected area. b. Alert Company and Contractor personnel. Alert adjacent operations. Dispatch necessary personnel, equipment, and material to the scene. C. Ensure that no persons enter the scene until determined safe by the Lead Plant Operator. 2. The Communications Center / Lead Plant Operator shall: a. Alert Company and Contractor personnel to ensure the safety of those who may be working along the same system. Dispatch necessary personnel, equipment, and material to the scene. b. Provide assistance in the event of an evacuation. c, Establish and maintain communications with the Lead Plant Operator. d. Assist the Plant Operator or authorized designee with the preparation of a log of incident events and scene photographs. 3. The Lead Plant Operator, or their designee shall determine the need for notification of: a. Public utilities. b+ Additional employee team members if additional areas are to be shut in. c. Operations Manager. d. R egul atory agency. 4. Site Security a. Once the source of the gas has been shut off and the any fire extinguished, the plant shall be kept clear of all personnel other than those of the Company or of an approved Contractor. b, once the area has been determined by the Operations Manager to be safe for long term entry by Discovery Midstream personnel and contractors, work maybegin on repairing the plant. Repairs may commence upon approval of Management. 5. Return to Service a. As each incident may contain unique elements, a plan for returning to service will be prepared for each incident, in accordance with the Purging Procedures in the Discover Midstream Ft Lupton Plant Standard Operating Procedures or the Operations and Maintenance Manual. b. Once the initial investigation criteria has been met, and the area has been approved to be returned to operation, a thorough investigation of the cause of the incident shall be made and action taken to prevent a re -occurrence. In addition, all phases of the incident, responses of various individuals and organizations, and results of the actions taken shall be reviewed to ensue plan effectiveness and continuity. Changes deemed necessary should be implemented as quickly as possible. Page 27 of 43 1' r} i "' r -j r Document #: 2.2 Revision #: 11 Revision Date: 7/21/2017 Document Name: DiscoveryEmergency Response Plan (DERRY}1 Location: Section 2 — Incident Reporting and Management Medical Emergency First Person on Scene: I. Do not move the victim. 2. Call warranted. 3. Call Discovery Operations Center 877a-6144183. 4. Give the following information: a) Your name and extension b) Name of victim c) Nature and cause ofinjury ur (if known) d) Exact location of the victim 6. Notify Supervisor. 7. Assist victim as needed. 8. Whenever possible, have an employee meet external Emergency Response Services in a nearby area to lead them to the victim, 8. If you are exposed to blood during the emergency, notify supervisor, Note: Employees are not required to render emergency assistance. However, periodic cardiopulmonary resuscitation (CPR) courses will be offered to employees that would like to learn this life saving procedure. An Automated External Defibrillators (AED) and First Aid Kit is located throughout the facility and may be used by trained personnel should they choose to do so. Page 28 of 43 Ll i Document #; 12 Revision #: 1 Revision Date: 7/21/2017 4 r fa ii ip- Document Name: Discovery Emergency Response Plan (DERP) Location: Section 2 — Incident Reporting and Management Spill Response and Chemical Release Discovering Party: If the Spill cannot be adequately and safely contained and cleaned up by work personnel: 1. Clear all employees from the immediate area to nearest and safest assembly area. 2. Call Discovery Operations Center 877-614-7183. 3. Report the following information: a) Name and phone number of person reporting incident. b) Exact location of spill. c) Material spilled. d) Estimated quantity e) Cause of spill 0 Current action taken for containment 4. DOC will contact Trihydro if spill cannot be contained and cleaned up by employees. 5. Notify Supervisor. 6. Do not return to the area until the "All Clear" is given by Operations Department. If a Chemical Release (Unfamiliar Odor) is detected: 1. Clear employees from the immediate area to nearest and safest assembly area. 2. Emergency Shutdown (ESD) will occur for whole facility or equipment. 2. Contact IOC 877-614-7183 3. Report the following information: a) Name and phone number of person reporting incident. b) Exact location of chemical release or unfamiliar odor. c) When known provide identity of chemical released. d) Current action taken to contain chemical release or prevent employee exposure to unfamiliar odor. 5. Notify Supervisor. 6. Do not return to the building/area until the "All Clear" is given by Operations Department. Discovery Operations Center: 1. Contact Trihydro if needed 800-359-0251. 2. Contact appropriate Discovery personnel. Spill Response Personnel: 1. Assess the situation. 2. Obtain Safety Data Sheet (SOS) for material spilled. 3. Obtain 90 Gallon Spill Clean-up Kit located at Operations/Warehouse Building (Appendix B). 3. Contain and clean up spill, if possible. Note: Employees are not required to perform spill response and should not attempt to do so if not properly trained. Page 29 of 43 Document 0: 2.2 IRevision #: 1 I Revision Date: 1 7/21/2017 Document Name: Discovery Emergency Response Plan (D ERP) ILocation: Section 2 — Incident Reporting and Management Natural Gas Emergency If You Smell Gas: 1. Do not attempt to locate the source. 2. Do not turn on/off electrical switches. 3. Do not use ANY phone inside the building. 4. Do not use an open flame or potential ignition sources 5. Evacuate the building using Exit. (Do not activate fire alarm system) 6. Call Discovery Operations Center 877-614-7183 or Fire Department 911 after exiting the building to a safe location. 7. Proceed Designated Muster Area. 8. Do not return to the building until the "All Clear" is given by Operations Department. Discovery Operations Center: 1. Contact Utility Provider. 2. Contact Director of Operations. 3. When needed contact Fire Department. Page 30 of 43 Document 0: 2.2 Revision #: 1 Revision Date: 7/21/2017 Document Name: Discovery Emergency Response Plan (DERP) Section 2 — Incident Reporting and Management Location: Bomb Threat If you receive a call or observe a suspicious object, Do Not Panic Person Receiving the Call: Make note of the caller's manner of speech, accent, background noises, etc. Use the Bomb Threat Information form to document your observations after the call is completed. • Call Discovery Operations Center 877-614-7183 and report the threat. • Do not tie-up the telephone line. Stay at your desk so you are available for any follow-up questions. • Direct employees to leave the building and assemble in area that is away from the reported threat Discovery Operations Center: Ti . Notify Director of Operations 2. Dial 911 or Notify Police Department. 3. Notify Operations Lead.. 2. Notify facility personnel Determination of Credibility: External Responders such as the Police Department will determine the credibility of the bomb threat based on information obtained during the call, along with results of the bomb search. The Police Department will search the building and make a determination of when it is safe to re- enter the building/area. Page 31 of 43 ' r Document #: 2.2 I Revision #: J I Revision Date: 7/21/2017 Document Name: Discovery Emergency Response Plan (DERP) Section 2 — Incident Reporting and Management Location: BOMB THREAT INFORMATION CHECKLIST INSTRUCTIONS: Be calm, courteous, listen, and do not interrupt the caller. Date: Time: Exact words of person placing the call: Questions to Ask: 1. Where is the bomb right now? 2. What kind of bomb is it? 3. What does it look like? 4. When is the bomb going to go off? 5. Why did you place the bomb? 6. Inform caller that the building is occupied, and the detonation of a bomb could result in the death or serious injury of many innocent people. This may elicit a response as to the actual location of a device. 7. What did you say your name was? Try to determine the following (Circle or Check as appropriate): Caller's Identity: Male / Female Adult / Juvenile Approximate Age: Voice: U thud O Soft ❑ High Pitch Accent: ❑ Local ❑ Not Local Speech: ■ Fast ❑ Slow O Distinct I Deep ❑ Foreign ❑ Region ❑ Stutter ❑ Nasal ❑ Slurred ❑ Raspy Q Pleasant ❑ Familiar ■ Other; • Other: ❑ Lisp ❑ Other: Manner: O Calm ❑ Angry i Rational Language: O Excellent r Good Background: i Trains ❑ Music Noises ❑ Irrational ■ Coherent ❑ Incoherent O Fair ❑ Poor IN Quiet O Voices O Animals ❑ Deliberate O Emotional IN Righteous ❑ Foul El Other: ❑ Office Machines ❑ Street Traffic O Factory Machines O Party ❑ Laughing ■ Intoxicated ❑ Other: Page 32 of 43 Document #: i : r rd.) I 7 ` r 4,)', 1 (Document 22 Revision #: I 1 t Revision Date: 7/21/2017 Name: Discovery Emergency Response Plan ( LSE RPM) Location: Section 2 — incident Reporting and Management Aircraft Emergency EMPLOYEES: 1. Contact Discovery Operations Center 877-614-7183. Discovery Operations Center: 1. Contact Director of Operations. 2. Notify Discovery Leadership Team, . If required contact; U.S. Department of Transportation Federal Aviation Administration Northwest Mountain Region Denver Airports District Office 26805 E. 68th Avenue, Suite 224 Denver, CO 80249-6361 Voice; (303) 342-1254 Fax: (303) 342-1260 Page 33 of 43 T Document #: 12.2 Revision #: 11 Revision Date: 7/21/2017 f- i * * '' ' A 1 'ti ' r '41 I,o 1r f Document Name: Discovery Emergency Response Plan (DERR) r Location: Section 2 — Incident Reporting and Management Inclement Weather (Tornado) 1. The Discovery Operations Center and Facility Operators will monitor weather broadcasts/bulletins on the Internet, Television, and Radio when changing atmospheric conditions may produce inclement weather. . If high winds are expected ensure unsecured items are either moved indoors or secured in some manner. 3. If a tornado is sighted within a twenty mile radius of the facility, Operations will notify employees of the tornado sighting and notify building occupants to move to a an internal room without windows i.e. bathrooms), hallway without windows, or designated shelter in place location. 4. Building occupants will remain in the shelter areas until the "All Clear" is announced by Operations Department. Page 34 of 43 4 ill ` s _ ( l .1 ,:. ':i : '. r t I 2.2 Revision #: I 1 I Revision Date: I 7/21/2017 Document #: Document Name: Discovery Emergency Response Plan (DERP) Location: Section 2 — Incident Reporting and Management Workplace Violence, Criminal Activities, Terrorism and Civil unrest 1. Any employee witnessing or learning of an unusual occurrence that might endanger personnel or encumber Company operations should immediately notify Discovery Operations Center 877-614-7183. 2. Employees should never take any action that endangers them or any other person. 3. Discovery Leadership will summon law enforcement personnel as necessary. 4. The appropriate course of action in response to civil unrest or acts ofterrorism must be determined at the time of the event. Discovery Leadership will notify facility occupants of any directions received from law enforcement agencies, public health agencies, or civil defense agencies. Page 35 of 43 re) I ail air 2.2 t Revision #: nin Document #: Revision Date: 7/21/2017 Document Name: Discovery Emergency Response Plan (DERP) Location: i Section 2 Incident Reporting and Management — Appendix A — Emergency Contact List T U IY 4 6yriPtr) EMERGENCY CONTACT NUMBERS Discovery Midstream Operations Center (DOC) 1-877-614-7183 First l espouse oordinator Office Cellular +dory Kline -- Director of perations (720) 378-6592 (970) 987-2527 Josh $race -- Operations Lread (720) 378-6592 (970) 776-6851 Manya Miller - Manager 'Engineering (720) 3 78 -6592 (9 70) 8 91-3 88 4 Corporate Office (Dallas) Office Cellular Cory Jordan — Chief Operating Officer (COO) (214) 414-1980 (318) 272-1018 Corporate Finance Office (214) 414-1980 N/A Media Re l a ti ons Casey Nikoloric — Ten/ 10 Group Office: (3 03) 433-4397 Cellular: (303) 507-0510 Hospital: Platte Valley Medical Center Emergency: Non -Emergency: (3 03) 498-1600 Ambulance: Poison Control: (800) 222-1222 Life F 1 i {ht Ern 10 _ - .. - (888 983-5881 Emer : enc : Non-Emer_ enc 911 (303) 857-4603 Air Quality Division: (303) 692-3100 Hazardous Materials and (303) 692-3300 Waste Management Division: USCG National Res ionse Center Hotline: (800) 424-8802 Health Safe Environmental HHS Consulting — Health and Safety Trihydro - Environmental Emergency: Office: (888) 492-8001 Cellular: (3 03) 8 09 -9401 Office: (800) 359-0251 Law Enforcement Fort Lupton Police Department Non -Emergency: (303) 857-4011 Weld County Sheriff Emergency: 911 State Hi zh a • Patrol Emer..enc 911 Weld Coun . Office of Emer. Inc liana lem.cnt Office: (970) 304-6540 Emergency After Hours: (970) 350-9600 Adams County Office of Emerscope Maria 4ement Office: (720) 523-6600 Emergency After Hours: 911 TJtiti . Com anv United Power: (303) 637-1300 E-470 Public Hi! hwa Author,i _. Non -Emergency: Emergency: Justine Brown (303) 537-3751 jbrown@e-470.com Chuck Weiss cweiss e-470.com (303) 537-3409 Page 36 of 43 C tee • M 7/21 lanagemeni ri Revision #: • N Document 4t: Document Name: Location: -"I* L i. I ' I L. • L,. rt rl k >• tt • •1 V I l F d. k I a i'S 'V % lit r I Y • 16 121 ` p T aft Wool wav r.U+• iMitil i u rth ti • I ,r 4 ~l 1 1 . a 1,050171";;';7 - it --- iff• .,-• 44 k VIII a i I Se SIP S 1 . • • A . 1 ♦ i i r I -I at 'F� I I I • • r• a 4 f �I~• • P I i p ea.*" y Y .40 .i{ 'T�r�1 Ni pp. p h I a Ivry r 1 I r . 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I 4 IS: k it ;1; 0. 1I kaistr t .ca -ac a I I 4,011A 3 I •I 0 I It ; 4Iw1 O w S 441 Ii I g Sat, Page 37 of 43 C4 co et ce) O w ;.1 'C1 tiv gal( to 2 I F P l i a ti tg a !- LW t8 z W .I 2 0 N 4' 1 a Y f r r F 0 • U -n, I tra n bir Ss.. e+a'na' i#s w4r WPM • p -Amapa a 2 W Ui J I, I a t = 1 a E N •dug dui U CC CL `'', Document it: 2.2 Revision #: 11 I Revision Date: 7121/2017 Discovery Emergency Response Plan (D ER NN Document Name; Location; Section 2 — Incident Reporting and Management Appendix D — Accident Analysis Report (Example — Page 1) Employer Flexible" Impact what matters' Report Only ■ Seeking Medical Attention ■ Accident -Analysis Report Workers' Compensation claim number: OSHA 300 case/file number: PART 1: Identification Information Employee name: Date of accident: Occupation: Department: Time: Shit Last 4 of Social; a, m. ■ P. m. ■ PART 2: Supplementary Information Company: Mailing address: City: Telephone Establishment location (if different from above) State: ZIP code: Accident location • Same as establishment? ■ Other Location? (Check if applies) if Other, Specify: Employee name; Employee address: Telephone City: • State: ZIP code: Does the Employee Speak English? Yes • No If no, Specify Language: Was injured person performing regular job at time of accident? • Yes • No Length of service in current position: Time shift started: a.rrt ■ p.m. • Witnesses? El Yes r No Name of Witnesses: Name of physician or clinic: Address of physician or clinic: Length of Service in Occupation: City Fatality? 0 Yes ■ No If yes, date of death: State ZIP code Page 39 of 43 a Document*: -- 2.2 Revision #: I Revision Date: 7/21/2017 1- ea or. ; I r ) Document Name: Discovery Emergency Response Plan (DERP) I Location: Section 2 — Incident Reporting and Management Appendix D a Accident Analysis .Report (Example -- Page 2) e Employer Flexible Impact what matters" 1M Accident -Analysis Report PART 3: Description and Analysis The description should include important event(s) that led up to the accident, injury or illness. They should describe the nature of the injury or illness, the body part affected, specific tasks being performed, what specific equipment or substance was directly involved (include name or brand), where the work was being performed, what specific task was the employee performing (was time a factor?), and what general type of accident occurred. Include weather/environmental conditions if necessary. Attach photos of accident scene machinery, equipment and/or police report numbers as well as additional description pages as appropriate. Description: PART 4: Training Did employee receive s ecific training or documented instructions relating to safety and health on the task(s) being performed? ■ Yes No If Yes: Type: Instructed by: When instructed: Attach appropriate training documentation„ Length of training: Page 40 of 43 r A Document #: 2.2 Revision It: 1 Revision Date: 7/21/2017 Document Name: Discovery Emergency Response Plan (D ER P) Location: Section 2 — Incident Reporting and Management Appendix E — Past Injury Treatment Authorisation for Preferred Provider Networks Form (Example - Page 1) Past Injury Treatment Authorization for Preferred Provider Networks e Employer Flexible" Impact what. matters` Injured Employee Information Name: Last 4 of SSN: DOB: Patient must present photo ID at time of Service Employer Information Company Name: Client Number Company Address: PEC/Third Part Administrator (TPA): Employer Flexible --WC Injury Protocol Authorized by: Title: Phone: Date of Authorization: After Hours Phone: Due to the nature of these specific services, only the patient Work Related Physical Examination and staff are allowed in the testing/treatment area. Please Date of Injury: alert your employees so that they can make arrangements for children or others that might be accompanying them to the medical center. Substance Abuse Testing Post -Accident Type of Test Non -DOT -10 panel Hair Collect Breath Alcohol Page 41 of 43 r jik .c d ' r ! Document It: 2.2 i Revision #: 1 I Revision Date: I 7/21/2017 Document Name: Discovery Emergency Response Plan (DERP) Location: Section 2 — Incident Reporting and Management Appendix E — Post Injury Treatment Authorization for Preferred Provider Networks Form (Example - Page 2) Special Instructions/comments: Company has modified duty available. Please be advised that company prefers over the counter medication vs. prescription medication due to OSHA recordkeeping requirements. Billing: Refer to Employer Flexible WC Protocol Attn: Lynn Collins Phone: 281.377.7604 Fax: 281. 77.7029 Employer Flexible Safety Et Risk Risk Main: 1.888.983.5881 risk@employerftexible.com Page 42 of 43 Document #: 12 J Revision #: I 1 i Revision Date: I 7/21/2017 Document Name: Discovery Emergency Response Plan (DERP) Location: Section 2 —Incident Reporting and Management Appendix F — Employees Notice of Injury (Example) Employees Notice of 7850 North Sam Houston Parkway West, Suite Houston, Texas J7'064 Phone: 281.377.7604 Fax: 281.3 77.7029 Injury 10tk Employee Name fast, first., middle) Social Security N: Phone: Street Add ran City State Zip Code Occupation: State where employment agreement was made: Average weekly wage: Length of employment: Months Years r ` Date of Accident of last Exposure: Time: AM PM Place of Injury: City/County/State Body Parts Injured: Describe in detail how the injury occurred. Treating Physician (full name: Address: City: State: Zip: Name of Co -employer Job site location: Are you a previously impaired person due to prior workers' compensation injury or obvious preexisting disability caused by accident, disease, birth defect or military injury that may impact the treatment of this injury? If infest please describe: Date: Description: Physician: Any person receiving temporary disability benefits from an employer or the employer's insurance carrier shall promptly report in writing to the employer or insurance carrier and change in material fact, or the amount of income he/she is receiving, or any change in his/her employment status, occurring during the period of receipt of such benefits. I declare under penalty of perjury that I have examined this notice and claim, and alt statement contained herein. and the best of my knowledge and belief, they are true, correct and complete. Any person who commits workers` cornfiensation fraud, upon conviction, shall to guilty of a felony., Upon Filing this Notice of Accidentat Injury and Claim for Compensation permission is given to the Administrator of the Workers' Compensation Court, the insurance Commissioner, the Attorney General, a District Attorney, the Insurance adjuster or their designees authorizes them eccess to medical records,, including waiver of any privilege granted by law concerning communications made to a physician or health cart provider or knowledge obtained by such physician or health tare provider by personat examination The information authorization for release may include information, which may be considered, a communicable, or venereal disease which may include but not limited to diseases such as hepatitis, syphilis, gonorrhea, and the human immunodeficiency virus, also known as acquired deficiency syndrome, Signed this day of - - Employee Signature This form constitutes a medlca$ authorization for release of medical evidentiary privilege try law. Printed Employee Name records. Nothing shall be constructed to waive, limit e Employer Impact Employer Flexible Copyright 2013, or Impair Flexible"' what any matters' Alt rights reserved Page 43 of 43 DISC o VERY Keenesburg Pipeline Project Weld County Stakeholders Neighborhood Meeting Notice Details Wednesday, August 29, 2018 5:30- 7:00 P.M. South East Weld County Fairgrounds Event Center 7758 CO Rd 59, Keenesburg, CO 80643 Purpose Discovery DJ Services, LLC is holding an informational meeting for the community to discuss its pipeline project, the Keenesburg Pipeline, which is a 24 -inch natural gas pipeline. This project will originate in Weld County between WCR 4 and WCR 6 just west of WCR 61. It will travel north between WCR 61 and WCR 63 and will terminate north of WCR 18 between I-76 and the 1-76 Frontage Rd I WCR 398. The total length is approximately 9 miles. Discovery is holding this meeting to inform neighbors and landowners and to seek their input prior to submitting permit applications with Weld County, This will be an Open House style meeting with experts from different groups across the project, We hope you can join us to provide input before we submit our applications. Please note that the pipeline route crosses only the properties shown on the attached map. Discovery has currently contacted all land owners along the preferred route. If you do not have an agreement, or are not in the process of executing an agreement with Discovery, this pipeline will not cross your property. Construction is expected from February 2019 through May 2019. If you have questions or need any information before the meeting, please feel free to contact: Zach Moran zmoran@discoverymidstreamecorn Owner Chris Glover Damon Roehrich S4 Farms LLC Michael J Coan John O Wagner Clifford A Harvey Douglas A Wilson Charles E Auer 1.841 Sigwardt Family Farm LLC Sean Stepanoff Rebecca Brown Jason Lee Stolz Judy A Roskop Lambert Investment 1 LLC Rose Lee Persiehette Jason Fox French Kauffman Brothers Limited Partnership Kauffman Brothers Ltd Partnership Keenesburg- 2 " Natural Gas Pipeline —9Mlles February - May 2019 Primary Parcels Address 1113 County Rd 61 30270 County Rd 6 3747 County Rd 59 28240 County Rd 10 29321 Highway 52 3943 County Rd 63 355 E 55th Ave. 4550 County Rd 61 2 168 45th Ave. PO Box 634 3 318 County Rd 14 30501 County Rd 14 30141 County Rd 14 155 E Bridge Street 30260 County Rd 16 112 30455 County Rd 16 1/2 8616 County Rd 63 2400 E Cherry Creek South Or., Unit 306 City / State I Zip Keenesburg, CO 80643-8400 Keenesburg, CO 80643-8415 Keenesburg, CO 80643-9428 Keenesburg, CO 80643-9415 Keenesburg, burg, O 80643-8704 Keenesburg, CO 80643-8605 Denver, CO 80216-1702 Keenesburg, 80643-8727 Greeley, CO 80634-3238 Keenesburg, CO 80643-0634 Keenesburg, burg, 80643-8713 Keenesburg, CO 80643-8714 Keenesburg, O 80643-8714 Brighton, CO 80601-1612 Keenesburg, CO 80643--9109 Keenesburg, CO 80643-9110 Keenesburg, CO 80643-9129 Denver, CO 80200-3255 Parcel 147730200030 147730 0023 147719000007 147719400002 147719100019 147718400034 147718000026 147718100028 147707000026 147707000023 147707200030 147706000002 147706200005 147706200004 147706200024 130331000011 130331300014 130331200008 130330300023 130330200006 130330200007 1303301 00003 130319000005 13032 0000007 130317000010 Owner Carolyn S Cobb 3W Farms LLC Robert J McClellan Chris C Bailey Samuel E Befus Garrett Curry Marie Hergenreder d o James Hergenreder Joey Pacheco Gerald W Guildner Ronald E Shoeley Daniel Quedenfeld V Living Trust Charles E Windholz John D Tietz Ronald M Rome Gregory L Leconte Kenneth L Carlson Expedition Water Solutions DF Basin LLC Guttersen Ranchers LLC Gary Douglas Myers Donald Pfertsh Keenesburg- 24" Natural Gas Pipeline at 9 Miles February w May 2019 Surrounding Properties - 150' Address City I State I Zip 30040 County Rd 6 Keenesburg, CO 80643-8415 27570 County Rd 10 Keenesburg, CO 80643a944-1 30545 County Rd 6 Keenesburg, O 80843,-840 30263 County Rd 8 3098 County Rd 61 3508 County Rd 61 1358 Trail Ridge Rd. 4545 County Rd 63 5135 County Rd 63 5263 County Rd 63 16712 Cathedral Way 30523 County Rd 14 6449 County Rd 63 7319 County Rd 63 PO Box 122 30075 County Rd 18 1023 39th Ave., Suite E PO Box 2176 PO Box 11232 1963 County Rd 61 Keenesburg, CO 80643-8628 Keenesburg, burg, O 80643-8613 Keenesburg, CO 80643-8618 Longmont, CO 80504-8745 Keenesburg, CO 80643-8738 Keenesburg, CO 80643-8736 Keenesburg, CO 80643-8736 Broomfield, CO 80023-4645 Keenesburg, CO 80643-8714 Keenesburg, CO 80643-8702 Keenesburg, 0 80643-9126 Keenesburg, CO 80643-0122 Keenesburg, CO 80643-9114 Greeley, CO 806342502 Greeley, CO 80532-2176 Englewood, CO 80151-1232 Keenesburg, burg, 80643-8400 Parcel 147730000012 147730000002 147719400001 147718300004 147718300005 14 77182 00015 147718000001 147707000027 147706000011 147706400007 147706400008 14 7706400006 130331000001 130331000003 130330400024 130330100001 130319000010 130318000011 130308000003 1303100 00003 147525100004 147525000027 Keenesburg- 24" Natural Gas Pipeline me 9 Miles February a May 2019 Surrounding Properties - 250' Owner Perkins Land & Livestock Marcus A Diamond Joan Pfeffer Juston Hrubes Steve R Auer Address IV LLC 194 Main St 3143 Lynwood Ave 30589 County Rd 8 30457 County Rd 8 30350 Highway 52 City I State /Zip Unionville, MO 63565-1658 Highlands Ranch, CO 80126-8046 Keenesburg, CO 80643-8628 Keenesburg, CO 80643-8628 Keenesburg, CO 80643-8709 Parcel 147730100020 147719100014 147718000023 147718300002 /477070009 gliqc I : 00 Y) tvl DISC o VERY MIDSTREAM PARTNERS Printed Name (attendee) it7-5 Self? t( • Facility/Pipeline: O. Mailing Address 5525 4. it a :2 C_ CiC.5? 7 eive31L. r e) Community eetin Location: u Mile Citiet ra-A4 C. 0 LAS\ tit) firic rt: � ,P0(eickli Contact Number r • 73t _ 303 IW OZdZ ,3CO3 -3% y 4 DISC VERY August 29, 2018 5:30 pm 7:00 pm Community Open House Location: Community Open House Notes Proposed Pipeline: Keenesburg Pipeline South East Weld County Fairgrounds Event Center 7758 CR 59 Keenesburg, CO 80643 Large printed and digital materials were present throughout the meeting room, and included pipeline drawings, and aerial photography overlays of pipeline and proposed site boundaries. A presentation was made available which covered information regarding corporate overview, local leadership, EHS culture, and project specific details. As attendees arrived, they were greeted by Company personnel, asked to sign -in, and shown information about the site, project, design, construction and future operation of the Keenesburg Pipeline project and associated begin/end points. With each member of the public in attendance, questions were asked/answered by representatives after a review of the other area gathering pipeline, compression/dehydration process, construction timeline, facility operations, and emergency preparedness. Personnel from engineering, operations, maintenance, land, and compliance were available to answer questions all evening. What follows is a summary of the questions and answers discussed during the meeting. Q1: What kind of traffic can we expect from this project? A: As with any construction project of this size, there will be traffic pattern interruptions and maybe some minor delays in one direction on surrounding roads. Our goal is always to minimize construction traffic impacts and keep pipeline construction work and traffic off area roadways and on the construction right-of-way (ROW) as much as possible. 0: How far will the project be from the property line? A: Pipeline centerlines must be within the identified pipeline ROW. We typically try to abut the property lines with the low, but this is contingent on any preexisting encroachments that may already existing on the property. What are the setback requirement? A: There are no federal setback requirements that Colorado homeowners must abide by regarding piping. ROW restrictions are specific to individual parcels and landowners, so you should always refer to any language specific to your agreement documentation for references to individual setbacks, if applicable. Q: How do you access the pipeline when it's at the back of a property? A: Access agreements are negotiated on an as needed basis whenever additional access is needed above and beyond what may have been initially negotiated. 1 ISC o VERY Proposed Pipeline: Keenesburg Pipeline Q: How deep is the pipeline buried? A: The minimum depth of cover at the end of pipeline construction is at least 48 inches. This may be more depending on location and installation methods. ,: Will most of the traffic be on CR 61 or CR 63? A: WCR 61 and 63 will have slightly more than the typical amount of traffic, but other cross -streets may also be used to lessen congestion on these main roads. C: How will you maintain the roads? A: Prior to construction, an access agreement will be negotiated with the appropriate governmental agencies or departments. That agreement will stipulate how roadway damages can be corrected should any occur. Q: What is the timeline for this project? A: Construction is scheduled to start in February of 2019 and continue through May of 2019. Q: Where will this pipeline be place, in the road or on private property? A: This pipeline will be built on private property. Q: Does your company do any drilling? A: Discovery is not a production company and does not drill wells. We have contracts with production companies to move their produced oil and gas to market. 0: There is already a pipeline running along this area, why► are you installing another one? A: Existing pipelines in the area are likely moving product from other producers. We are installing a pipeline that will gather product from new sites in that area. Q: How do I know if there is a leak? Will it have a rotten egg smell? A: There are several ways to identify if a pipeline may have a small leak and a rotten egg smell may be one indication. You may also notice wilted or yellow grass near a pipeline right of way when all the other vegetation around is lush green. Another indication may be a hissing or blowing sound coming from the ground. C: Do you negotiate with the other companies if you are near their pipelines? A: Yes, we communicate with all foreign pipeline companies that we cross during our construction to assure that we do not interfere with or damage any existing pipelines. Q: What are the plans to keep the dust down? A: Wa typically determine a dust mitigation prior to starting the project and review its effectiveness periodically to ensure we are taking the correct measures to keep the dust down. Some examples of dust mitigation that we use include having a water truck onsite that can spray► the access road to keep the dust down as well as imposing speed limits on the construction crews in the work areas as needed. Q: How is the pipeline put in? A: At the time the construction contractor is ready to lower the pipe in, the pipe will be strung out along the right of way and welded together in segments. The construction team will use machinery 2 ISCOVERY Proposed Pipeline: Keenesburg Pipeline such as a trackhoe to dig a trench and then the pipe will be lowered into the trench using sidebooms. nos. Tie-in welds will be made to connect each section of the pipeline in the trench. After the welds, coating, etc. are inspected and approved, that crew will continue forward to the next section and another crew will follow behind them to backfill l l the previous section. Q: Why do you need to install another pipeline and who will benefit from it? A: The need to build another pipeline can be due to many different reasons such as existing lines being at/near capacity, new producers in an area that don't currently have infrastructure to move their product, etc. Without a pipeline in place, the oil and gas from a well pad would need to be transported by truck for processing, so there is a local benefit to the community by mitigating heavy truck traffic. There are long term cost savings to the producer by installing a pipeline as opposed to paying for trucking/rail services. There are also potential benefits to using local resources such as natural gas to lower a ne rgy costs for residents of local communities. Q: How do you pick your route? A: The route is based on the area the project will be servicing and landowner who are willing to work with us to have the pipeline on their property. Q: How will the area be revegetated? A: Upon completion of pipeline construction, the topsoil will be placed back on the right of way and our contractor will re -seed the right of way. The requirements for the type of seed mix will be determined by the county, state, or property owner in the right of way agreements. Q: How often after construction will the pipeline be checked, and will there be heavy equipment on site after construction is complete? A: Discovery Operations drives the pipeline route bi-weekly as part of the operations and maintenance plan. Normal operations after construction is complete will not require heavy equipment. Q: Will there be any above ground sites along this route? A: There are no plans for aboveground sites along this route aside from the valve sites at the start and end of the pipeline. 0: Why do you do open trench cuts and not bore the whole pipeline? A: It is much more cost effective to open cut the trench and use the conventional lay method as opposed to boring the whole pipeline. Horizontal Directional Drills and bores also take significantly longer for construction as opposed to open cut, so utilizing the open cut conventional lay method decreases the overall time to construct a pipeline. 0: Will this new pipeline help with all the truck traffic in this area? A: Installing the pipeline will decrease heavy truck traffic to the well pads that it is servicing since pipelines are much more efficient in gathering/transporting oil and gas as opposed to trucking them from the well pads. 3 Hello